Angiography

Angiography is one of the main examination methods in vascular medicine. The name comes from the prefix angio- (blood vessel) and suffix -graphy (imaging).

Principle

The examination is performed in horizontal position on examining table in local anesthesia. The procedure aims to enter the arterial system by a syringe. The main access area is usually in the groin (femoral artery) or upper extremity (radial artery).The syringe is hollow and the intervention allows us to insert a thin wire through the needle into the artery. The examination continues by application of a contrast agent into the bloodstream, which flows through the arterial system. By simultaneously performed X-ray, the doctors are able to see the flow of the contrast through the arteries and find any narrowed or closed areas. The images are stored in computer and can be reevaluated later.

 

Angiography may be also a therapeutic method. When there is a narrowed or closed artery, it is possible to dilate this place with a special balloon (angioplasty) and support the previously occluded space by a tube-shaped hollow device known as sent to prevent repeated narrowing or closure.

 

After the examination is ended, the place of puncture should be compressed for some time. The compression decreases the risk of local bleeding and occurrence of large bruises.

 

Importance

The biggest importance is in examination of arterial diseases. Angiography can confirm atherosclerotic narrowing or closure of all main arteries such as coronary arteries (coronary angiography), arteries of the lower extremities (peripheral vascular disease) and renal arteries (narrowing of the renal artery). Angiography of the aorta may be indicated to confirm aortic dissection or aortic aneurysm.

Preparation

The patient should be fasting before the procedure and preventively treated with anti-allergic drugs. Some of these drugs may have a mild sedative effect to decrease anxiety.

Problems

The examination has a risk of arterial bleeding from the puncture.  The risk is higher if the patient has impaired blood clotting, or when compression after the procedure is not performed correctly. In addition, there may be an allergic reaction against the administered contrast medium. Fortunately, the allergic reaction is usually not life-threatening and the doctors are able to quickly administer anti-allergic drugs intravenously. The contrast medium can also overload kidneys and cause their acute failure, especially in patients with previous kidney disease. Adequate hydration after the procedure is the best prevention of renal damage.

Benefits

The method is great in diagnosis of arterial diseases, usually the complications of atherosclerosis. In addition, the angiography is in many cases able to cure these disorders. Despite it is an invasive examination, it is virtually painless as the only mild pain is present only during the arterial puncture.