Angiography

What is angiography?

Angiography is an X-ray examination of your arteries that can be used to look at arteries throughout the body. It can give your doctors exact information about your arteries and help them plan the best treatment for you. This procedure is performed by an interventional radiologist, a physician who specializes in minimally invasive, targeted treatments using imaging for guidance.

During the angiogram, the interventional radiologist inserts a thin tube (a catheter) into one of your arteries through a very small nick in the skin, about the size of a pencil tip. Contrast (X-ray dye) is then injected into the artery while X-rays are taken of the area. The contrast makes the artery visible on the X-rays. The angiogram helps your interventional radiologist and other doctors plan the best treatment for you.

Why do I need an angiogram?

One of the most common reasons for an angiogram is to find out if a blocked artery is causing your symptoms. For example, a blocked artery in the leg may cause pain in your leg when you walk; in the kidney it may cause high blood pressure; and in the brain it may cause vision problems and weakness.

An angiogram can determine exactly where the artery is obstructed, how severe the blockage is, and what is causing it

The two most common causes of blocked arteries are a blood clot in the artery and atherosclerosis (hardening of the arteries caused by a build up of plaque).

Another common reason for an angiogram is to see if you have an aneurysm, which is an area of an artery that has ballooned out. Although other medical tests, such as physical examination, ultrasound, computed tomography (CT) scan, or magnetic resonance (MR) can detect an aneurysm, an angiogram may be necessary to see it in detail and to plan treatment.

Angiograms also are used to diagnose difficult problems not resolved by other tests. They are also sometimes used by physicians to help choose the best procedure for you.

Before your angiogram begins, a member of the interventional radiology team - the doctor, nurse, or technologist - will talk with you about the procedure in detail and answer any questions you have.

What is an angiogram like? Does it hurt?

An angiogram has three major steps: insertion of a small catheter into your body, injection of contrast into an artery while X-ray images are obtained and removal of the catheter.

  1. Catheter insertion - A member of the interventional radiology team will wash the skin where the catheter will be inserted. This area is usually at the top of the leg or on the upper arm. The doctor will then give you a local anesthetic to numb the skin and deeper tissues. After that, you will only feel pressure when the catheter is inserted into the artery through a tiny nick in the skin. The doctor will guide the catheter to the artery by viewing it on an X-ray screen. You will not feel the catheter moving through your arteries.
  2. Contrast injection - When the catheter is in the correct position, contrast will be injected through it while X-ray pictures are taken. Sometimes you will feel warm inside when the contrast is injected, but that only lasts for a few seconds. In most cases, several contrast injections and several sets of X-rays are needed to complete the examination.
  3. Catheter removal - After the examination is finished, a member of the interventional radiology team will remove the catheter from your artery, which does not hurt. Pressure will be applied to the place where the catheter was inserted for 10 to 20 minutes. This pressure stops bleeding and stitches are not needed. The angiogram usually takes one or two hours to complete. In some cases, it may take longer. In other cases, the interventional radiologist will do a second procedure, such as an angioplasty, at the same time as the angiogram, making the procedure longer.

Reprinted with permission of the Society of Interventional Radiology (c) 2004, 2008; www.SIRweb.org. All rights reserved.


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