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Artemis

Angiography- Definition, Indications, Contraindications, Techniques, Complications, And Clinical Significance

Artemis Hospital

April 03, 2024 |
9 Min Read | 114

An angiography is a diagnostic procedure that uses X-ray images to check blockages in your blood vessels. This test allows your healthcare provider to see how blood circulates in blood vessels in particular areas of your body. They use an angiography of your heart, neck, kidneys, legs, or other areas to locate the source of an artery or vein issue.

Indications

Your doctor may recommend angiography if you experience symptoms of a blocked, damaged or malformed artery.An angiography test assists your doctor in determining the source of the problem and the amount of damage to your blood vessels. An angiography test can help your doctor diagnose and/or plan treatment for diseases like:

An angiography includes injecting contrast dye into your body so your doctor can see it with an X-ray machine. Images on a screen show blood flow and blockages in your blood vessels.

Preparation

Before your angiography test, your doctor may want to check your blood to see how well it clots. They also want to make sure your kidneys are performing properly.

Follow these instructions after midnight the night before your exam:

  • Always consult your doctor before discontinuing any medicine, particularly antiplatelet drugs and anticoagulants.
  • If your healthcare professional approves: 
  • Avoid taking aspirin or any products containing aspirin.
  • Do not take blood thinners for 72 hours before or 24 hours after the test.
  • Do not take clopidogrel for five days before the scheduled date of the test.
  • Take your other medicines as usual.
  • If you have diabetes, consult your doctor for information on when and how to take your insulin and/or medication.

Follow all the instructions given by your healthcare provider.

On the day of your angiography, you’ll need to:

  • Keep your valuables at home, including jewelry.
  • Make arrangements for someone you can trust to drive you home.
  • Bring a list of the current medications and allergies.
  • Inform your healthcare providers that you have diabetes.
  • Change into a hospital gown and lie down on a specialized X-ray table.
  • Meet with your healthcare practitioner to go over the instructions, questions, and medical history.

During The Test

  • During an angiography procedure, the provider will numb the area where the catheter will be placed.
  • A needle is used to gain access to your blood vessels and wire is put through the needle.
  • Insert the catheter slowly and cautiously through your artery until the tip reaches the area of the blood vessel that needs to be examined.
  • Inject a small amount of contrast material (dye) into the catheter and the blood vessel. For an initial few seconds, this may cause you to flush or feel the need to urinate.
  • Take x-rays.
  • On the X-ray monitor, look where the contrast agent goes to find where and how smoothly blood moves in your blood vessels.

If your doctor discovers a blockage, he or she may perform an angioplasty immediately. This method uses a small balloon to press the blockage against the arterial wall. An angioplasty may be all you need if it improves blood flow and leaves less than 30% of the blockage after the treatment.

If an angioplasty fails to produce a large enough opening for blood to pass through, you may require a stent. This small metal tube remains inside your blood vessel to keep it open. Your provider can perform this immediately following your angioplasty.
If a stent is also not best suited for an individual then another technique, bypass surgery is recommended in that case. 

After The Test

Your healthcare practitioner will remove the catheter and bandage the punctured area in your skin. They will apply pressure to the bandaged area for at least 15 minutes to stop or prevent bleeding. If doctors insert the catheter through your leg, you will need to be in bed for four to six hours. This reduces the likelihood that your incision will bleed. Before you leave for home, your provider will assess you and go through at-home instructions.

Recovery

You should be able to leave the hospital on the same day as your angiography. After you return home, don't lift anything more than 4 kg or stoop or bend for the following two days. This should prevent the incision from bleeding. Some patients may need to spend the night in the hospital following their angiography procedure

Complications

The potential risks associated with angiography are low. However, complications can occur in the area where your provider punctured your skin to reach your artery. Angiography problems occur in less than one percent of cases.
The risks of an angiography procedure usually involve your puncture site and consist of:

  • Bruises(common and go away in one to three weeks)
  • Bleeding
  • Infection
  • Pain
  • Kidney issues
  • An allergic reaction to the contrast material (dye).
  • Injury to blood vessels.
  • A blood vessel blockage that could cause a heart attack or stroke (rarely).
  • A blood vessel leak (rarely).

Complications of Angiography

Access site bleeding/hematoma

Minor adverse events include a small amount of bleeding or bruising at the access site or a small hematoma. A hematoma is a contained collection of clotted blood outside the artery. Access site hematomas are usually small and require no specific therapy. They occur in less than 3% of patients.

A hematoma is considered a major complication if any of the following occurs: a blood transfusion is required; surgical evacuation is necessary; readmission to the hospital; prolonged hospital stay. Major bleeding complications are rare and have not yet been reported in UFE patients.

Vascular Damage

Artery walls can suffer injury during entry and further administration of the catheter(small plastic tube). Serious problems that require hospitalization, surgery, other invasive interventions, or hospital readmission are rare.

Contrast-related

Iodinated radiography contrast can cause temporary or chronic renal failure. This usually occurs in patients who already have problems with kidney function, such as diabetics. The tiny amount of contrast utilized during the test does not seem to pose a risk of renal failure in otherwise healthy people.

Some people are allergic to contrast agents. Usually, this is mild, with the most common symptoms being a rash or hives that resolve quickly in most cases. Approximately 1 in 4000 people will experience a more significant reaction, such as severe asthma or airway swelling, requiring intravenous treatment and an extended period of care. An extreme (anaphylactic) reaction that ends in life loss is extremely rare.

Clinical Significance

Your healthcare professional may discover minor blockages that do not require additional treatment. You may need to take medicine or make adjustments to your usual routine. For example, you may need to increase your physical activity or eat healthier. You may have larger blockages requiring more extensive therapy. Your doctor may perform an angioplasty and insert a stent to keep your artery open. They can perform this during your angiography procedure.

Some patients require an additional procedure on another day. Your doctor may propose a bypass procedure that allows blood to flow around the blocked area.

Conclusion

Angiography is one of the most effective tools for diagnosing and treating vascular disorders. It provides a detailed view of blood vessels and enables healthcare professionals to detect blockage, any abnormalities, and blood flow problems. Early detection and quick intervention have led to saving lives and improved outcomes.

Frequently Asked Questions

Q1: Is angiography painful?

A: A long, thin, flexible tube (catheter) is placed into the artery and gently directed to the area under examination; you may feel some pushing and pulling during this process, but it should not be painful.

Q2: Can angiography clear a blockage?

A: A method called angioplasty may be used to treat narrowed coronary arteries during an angiography. To remove the blockage, a special catheter is inserted through the blood channels and into the coronary arteries. Another surgical option for severely narrowed coronary arteries is bypass surgery.

Q3: When should I call my doctor?

A: Please contact your healthcare provider if you have:

  • Persistent pain or discomfort.
  • Having difficulty speaking or smiling.
  • The arm or leg they were working on may have swollen, become heated, or become numb.
  • Fever.
  • A lump near the wound.
  • Bleeding at the area where the catheter was inserted.

Q4: Who performs an angiography?

A: An interventional cardiologist performs an angiography. Interventional radiologists and vascular surgeons perform angiography of peripheral arteries. Interventional neurologists perform cerebral angiography. The provider who performs the angiography can study your images and identify problem areas.

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