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What is angiography?

Angiography is the study of blood vessels by using x-rays. Angiography is an imaging procedure that uses x-rays to see any blocking, narrowing, enlarged or malformed blood vessels in your body. Angiography includes the study of blood vessels of brain, heart, abdomen and upper and lower extremities.

During angiography the contrast media will be injected into your arteries by using a catheter (tube) and it will be seen on the screen. Angiography is also called as angiogram.

Types of angiography:

1.Computed tomography angiography (CTA):

Computed tomography angiography is performed on the Computed Tomography machine in radiology department. In this procedure the contrast media is injected into the blood vessels using a catheter and then diagnose the disease related to the interested part. By angiography the image of major blood vessels throughout the body.

In CT angiography, the image of both blood vessels and the tissues related to that organ are produced. The contrast media is injected through a small catheter in the vein of the arm. The radiology technologist then capture high-resolution images during the contrast media flows through the blood vessels.

Indications for CT angiography:

  • Blockage in the blood vessel
  • Aneurysm (swelling of thickening of the blood vessels)
  • Blood clots
  • Vascular malformations (disorganized blood vessels)
  • Tumors
  • Injury
  • Vessel rupture
  • Congenital (birth related) abnormalities related to cardiovascular system (including the heart).

CT Angiography plays an important role in checking of blood vessels during the surgery, these include:

  • To identify the abnormalities of blood vessels such as aneurysm in aorta, or in other arteries.
  • To detect atherosclerotic (plaque) disease in the carotid artery of the neck, which may cause a stroke by reducing the blood flow in the brain.
  • To detect the narrowing of the arteries of the legs due to plaque disease and help in the preparation of the endovascular intervention or surgery.
  • To identify a small aneurysm or arteriovenous malformation (AVM), it is an abnormal connection between blood vessels of the brain or elsewhere.
  • CT angiography is also used to guide the interventional radiologist and surgeons to repair an unhealthy blood vessel by implanting stents or evaluation a stent after the implantation.
  • To detect pulmonary embolism (blood clots travelling from leg veins) by examine the pulmonary arteries in the lungs or pulmonary AVMs.
  • CT angiography is also used to detect if any tumor is feed by an artery prior the surgery or other procedures like radiation therapy or chemoembolization.
  • To detect injury to one or more arteries in the neck, chest, pelvis or abdomen after trauma.
  • To evaluate any obstruction and stenosis of vessels.
  • To check any congenital abnormalities in the blood vessels, especially in the arteries of children i.e. malformations in the heart or other blood vessels due to congenital disorders/disease.
  • To plan for a coronary bypass surgery.
  • To identify dissection in the aorta or its major branches.

2.Coronary angiography:

The coronary angiography is the angiography for heart vessels. A coronary angiography is a part of the procedure known as cardiac/heart catheterization. This procedure use to diagnose and treat the disease related to blood vessels of heart and heart. A coronary angiography which is used to diagnose the heart related conditions and it is most common type of cardiac catheterization procedure.

During the procedure of coronary angiography, the contrast media is injected in the blood vessels of heart and x-ray machine produces a series of images of the blood vessels. The doctor can also perform angioplasty (opening of clogged heart arteries) during an angiography if needed.

Indications for coronary angiography:

  • Chest pain due to angina pectoris
  • An unexplained pain in chest, jaw, neck or arm, unable to detect the disease by other diagnostic tests
  • Unstable angina pain
  • Congenital (birth related) heart disease
  • Blood vessels problem in chest or chest injury
  • Abnormal result of a noninvasive heart stress procedure
  • Heart valve problem that needed surgery

Complications after coronary angiography:

  • The coronary angiography has some risks to your body. There in a rare chance of major complications, other risks include:
  • Radiation exposure
  • Injury to the catheterized artery
  • Heart attack
  • Stroke
  • Allergic reaction to contrast media
  • Arrhythmias (irregular heart rhythms)
  • Excessive bleeding
  • Kidney damage
  • Infection

3.Radionuclide angiography:

Radionuclide angiography is a procedure of nuclear medicine department. It gives the detailed structure and function of the right and left ventricles of the heart. in this procedure a radioactive tracer is injected into the patient and a gamma ray involvement. It is also called as multigated acquisition (MUGA) scan.

4.Digital subtraction angiography (DSA):

Digital subtraction angiography is the imaging of blood vessels in brain. It is done for angiography of brain and to check the blood flow of vessels in brain.

5.Magnetic resonance angiography (MRA):

Magnetic resonance angiography is a part of Magnetic Resonance Imaging that uses contrast media. This contrast media is used to visualize the blood vessels. This study gives the detailed image of blood vessels these includes; angiography for brain, angiography of heart and angiography leg.

6.Renal angiography:

Renal angiography is also known as the arteriography. The image of blood vessels of renal/kidney is produced during the renal angiography. The renal angiography is done to look for the aneurysm (thickening) of blood vessels and stenosis (narrowing) of blood vessels.

The contrast media is injected to the artery that brings blood to the kidney. After that the images will be taken.

Indications of renal angiography:

  • Aneurysm (bulging of blood vessel)
  • Stenosis (narrowing of blood vessel)
  • Blood clot
  • Blockage
  • Complications after kidney transplant
  • Arteriovenous malformation

Preparation for angiography:

Angiography is performed in the catheterization (Cath) lab. Your doctor will instruct you about medications and specific instructions, and the general guidelines include:

  • Do not drink or eat anything 8 hours before your angiography procedure.
  • At the hospital you will be asked to change into hospital gown and sign the consent form.
  • Check your blood sugar level if you have diabetes.
  • You may also go under for an electrocardiogram and blood test.
  • If you have any allergic reaction tell your doctor.
  • Tell your doctor if you are pregnant or might be thinking you are pregnant.

Procedure of angiography:

Before the procedure:

Before going to an angiography procedure, your health care team will get a review of your medical history, previous allergies and your medications. The nurse will record your vital signs such as blood pressure and pulse rate.

During the procedure:

For the procedure you will lie on the x-ray table.

An Intravenous (IV) line is inserted in your arm. Depending on your procedure your doctor may give you anesthesia. Anesthesia is given to the patient to sedate them. The anesthesia will be given through IV route.

Throughout the procedure electrode on your chest monitor your heart. All other vitals are also checked throughout the procedure like blood pressure, pulse oximeter, and measurement of amount of oxygen in your blood.

The area from where the catheter will be inserted should be washed and disinfect with the antiseptic solution and numbed with a local anesthesia, and a small amount of hair may also be shaved from the area.

A small incision is made at the entry level, and a small plastic tube is inserted into your artery then the catheter is inserted through the tube into blood vessels and this catheter is threaded to the coronary arteries. This doesn’t cause any pain.

Contrast media is injected through the catheter. You may feel a warmth or flushing sensation, but if you feel any discomfort and pain tell the doctor.

The contrast media will be seen on x-ray image very easily. As it travels through your veins, your doctor can watch its stream and recognize any blockages or clogged arteries. It depends upon what your doctor finds during your angiography, you may have extra catheter systems simultaneously, for example, an inflatable angioplasty or a stent arrangement to open up a limited vein. Other noninvasive tests, for example, ultrasound, may enable your doctor to assess recognized blockages.

An angiography takes about one hour or more depending on other combined catheterization procedures.

After the procedure:

At the point when the angiography is finished, the catheter is expelled from your arm or crotch and the entry point is shut with manual weight, a clasp, or a little attachment.

You’ll be taken to a recovery zone for observation and monitoring. At the point when your condition is steady, you come back to your own room, where you’re checked routinely.

You’ll have to lie flat for a few hours to avoid bleeding the catheter was embedded in the crotch. During this time, weight might be applied to prevent bleeding and promote healing.  

You might have the option to return home that day, or you may need to stay in the emergency clinic short-term. Drink a lot of liquids to flush the contrast media from your body.

Ask your medicinal services group when to continue taking prescriptions, washing or showering, working, and doing other typical exercises. Keep away from arduous exercises and hard work for a few days.

Your cut site is probably going to stay delicate for some time. It might be somewhat wounded and have a little knock.

Result:

The results show that whether there is a normal blood supply or any blockage in the blood vessels. The result also show that how much blood flow is blocked by your blood vessels.  The abnormal results may show the blockage of one or more arteries. If you diagnosed with a blocked artery your doctor may perform another procedure such as angioplasty.