Angiogram

Jai Ganesh · Yesterday 23:00:25

Angiogram

Gist

An angiogram is a scan that shows blood flow through arteries or veins, or through the heart, using X-rays, computed tomography angiography (CTA) or magnetic resonance angiography (MRA). The blood vessels appear on the image after a contrast dye is injected into the blood, which lights up on the scan wherever it flows.

Angiography may be the first step of a procedure to find and fix a blood vessel blockage, aneurysm, structural heart or valve disease.

Summary

An angiogram is a type of X-ray used to examine blood vessels.

Blood vessels don’t show up clearly on ordinary X-rays, so a special dye is injected into the area being examined. The dye highlights the blood vessels as it moves through them. The medical name for this is a catheter angiogram.

Less commonly, angiograms can also be carried out using magnetic resonance imaging(MRI) and computerised tomography (CT) techniques.

Why angiograms are used

An angiogram can help diagnose conditions that affect blood vessels and the flow of blood through them. These include:

* coronary heart disease – the blood flow through the artery that supplies the heart muscle is disrupted because it has become narrowed
* aneurysm – a section of a blood vessel wall bulges outwards due to a weakness in the wall
* atherosclerosis – blood vessels become clogged up with fatty substances, such as cholesterol; an angiogram can be used to assess the level of atherosclerosis in specific blood vessels

Details

An angiogram is a diagnostic procedure that uses imaging to show your provider how your blood flows through your blood vessels or heart. An injected contrast material makes it easy to see where blood is moving and where blockages are. Your provider can use X-rays or other types of imaging for your angiogram.

Cerebral Arteriogram

An arteriogram is an X-ray of the blood vessels. It’s used to look for changes in the blood vessels, such as:

* Ballooning of a blood vessel (aneurysm)
* Narrowing of a blood vessel (stenosis)
* Blockages

This test is also called angiogram.

For arteriogram, your healthcare provider inserts a catheter into a large blood vessel and injects contrast dye. The contrast dye causes the blood vessels to appear on the X-ray image. This lets the healthcare provider better see the vessel(s) under exam.

Many arteries can be seen on an arteriogram, including those of the legs, kidneys, brain, and heart. A cerebral arteriogram is used to look at the blood vessels of the brain, head, or neck.

For a cerebral arteriogram, a catheter is usually inserted into an artery in the groin. Sometimes, an artery in the arm is used. Rarely, an artery in the neck may need to be used. The groin artery is most commonly used because it’s easier to get to. Once the catheter is inserted, the contrast dye is injected. Next, a series of X-rays are made. These images show the arteries, veins, and capillaries and blood flow in the brain.

What is computed tomography (CT) angiography?

CT angiography is a type of medical test that combines a CT scan with an injection of a special dye to produce pictures of blood vessels and tissues in a part of your body. The dye is injected through an intravenous (IV) line placed in your arm or hand.

A computerized tomography scan, or CT scan, is a type of X-ray that uses a computer to make cross-sectional images of your body. The dye injected to perform CT angiography is called a contrast material because it enhances blood vessels and tissues that are being studied.

Why might I need a computed tomography angiography?

* To find or measure the size of an aneurysm (a blood vessel that has become enlarged and may be in danger of rupturing)
* To find blood vessels that have become narrowed by atherosclerosis (fatty material that forms plaques in the walls of arteries)
* To follow vessels involved by dissections, which are tears that can form in the wall of vessels
* To find abnormal blood vessel formations inside your brain
* To identify blood vessels damaged by injury
* To find blood clots that may have formed in your leg veins and traveled into your lungs
* To evaluate a tumor that is fed by blood vessels

Information from CT angiography may help prevent a stroke or a heart attack. This type of test may also help your health care provider plan cancer treatment or prepare you for a kidney transplant. Your health care provider may have other reasons for ordering this test.

What is fluoroscopy?

Fluoroscopy is a study of moving body structures--similar to an X-ray "movie." A continuous X-ray beam is passed through the body part being examined. The beam is transmitted to a TV-like monitor so that the body part and its motion can be seen in detail. Fluoroscopy, as an imaging tool, enables physicians to look at many body systems, including the skeletal, digestive, urinary, respiratory, and reproductive systems.

Fluoroscopy may be performed to evaluate specific areas of the body, including the bones, muscles, and joints, as well as solid organs, such as the heart, lung, or kidneys.

Other related procedures that may be used to diagnose problems of the bones, muscles, or joints include X-rays, myelography ( myelogram ), computed tomography ( CT scan ), magnetic resonance imaging ( MRI ), and arthrography.

What is magnetic resonance angiography?

You’ve probably heard about the test called magnetic resonance imaging or MRI. In this test, radio waves, a magnetic field, and a computer create a scan of your body parts to look for health problems.

Magnetic resonance angiography–also called a magnetic resonance angiogram or MRA–is a type of MRI that looks specifically at the body’s blood vessels. Unlike a traditional angiogram, which requires inserting a catheter into the body, magnetic resonance angiography is a far less invasive and less painful test.

During magnetic resonance angiography, you lie flat inside the magnetic resonance imaging scanner. This is a large, tunnel-like tube. In some cases, a special dye, known as contrast, may be added to your bloodstream to make your blood vessels easier to see. When needed, the contrast is given with an intravenous (IV) needle.

What is a resting radionuclide angiogram?

Resting radionuclide angiogram (RNA) is a type of nuclear medicine test. Doctors use a tiny amount of a radioactive substance, called a tracer, during the scan to help show the heart’s chambers in motion. This test can tell the doctor how well the heart pumps and how much blood is pumped with each heartbeat. This is called the ejection fraction.

Your doctor injects a radioactive tracer (usually technetium) into an arm vein. The tracer “tags" blood cells so your doctor can track them with a scanner as they move through the heart. A special camera (called a gamma camera) then records the heart muscle at work, like a movie. Your doctor can match these recordings with the electrocardiogram (ECG). An ECG is a recording of the heart's electrical activity.

If the heart muscle doesn’t move normally, or not enough blood is pumped out by the heart, it may be a sign of one or more of the following:

* Injury to the heart muscle, possibly as a result of decreased blood flow to heart muscle due to clogged heart arteries

* An enlargement of one or more of the heart's chambers

* Aneurysm (a weak area in the heart muscle)

* Toxic effects of certain medicines

* Heart failure

Additional Information

An angiogram is a diagnostic procedure that uses imaging to show your provider how your blood flows through your blood vessels or heart. An injected contrast material makes it easy to see where blood is moving and where blockages are. Your provider can use X-rays or other types of imaging for your angiogram.

Overview:

An angiogram uses X-ray images and contrast dye to show blockages in blood vessels.

What is an angiogram?

An angiogram is a diagnostic procedure that uses X-ray images to look for blockages or narrow spots in your blood vessels (arteries or veins). An angiogram test can show how blood circulates in blood vessels at specific locations in your body. Healthcare providers use an angiogram of your heart, neck, kidneys, legs or other areas to locate the source of an artery or vein issue.

Your healthcare provider may want to do an angiogram procedure when you have signs of blocked, damaged or abnormal blood vessels. An angiogram test helps your provider determine the source of the problem and the extent of damage to your blood vessels.

With an angiogram procedure, your provider can diagnose and plan treatment for conditions like:

* Coronary artery disease (blockage or narrowing in the arteries that supply your heart)
* Peripheral artery disease (blockage or narrowing in your leg arteries)
* Blood clots (mass of blood cells)
* Aneurysm (weak artery wall)

Test Details:

How does an angiogram work?

An angiogram procedure involves injecting contrast material (dye) that your provider can see with an X-ray machine. Images on a screen show blood flow and blockages in your blood vessels.

Your provider will give you medicine to make sure you’re relaxed and comfortable. Most people receive sedation. Others get general anesthesia, which makes them sleep. Either way, someone will need to drive you home afterward.

How to prepare for an angiogram procedure

Before your angiogram test, your provider may want to check your blood to determine how well your blood clots. They also want to make sure your kidneys are working well.

Medications

Always consult with your provider before you stop taking any medication, especially antiplatelets and anticoagulants. With provider approval:

* Don’t take clopidogrel for five days before your procedure.
* Don’t take blood thinners like dipyridamole or warfarin within 72 hours before the test and 24 hours after the test.
* Take all other medications as usual.
* If you have diabetes, ask your provider for instructions about if and when to take your insulin and/or medicine.

Don’t eat anything after midnight the night before your angiogram. If you’re having general anesthesia during the procedure, don’t eat or drink anything after midnight.

The day of your angiogram

Be sure to:

* Drink only clear liquids for breakfast on the day of your procedure.
* Leave your jewelry and other valuables at home.
* Make sure you arrange for a responsible adult to drive you home.
* Bring a current list of your medications and allergies.
* Bring a book or magazine in case your healthcare provider has to handle an urgent case before yours.
* Let all of your providers know if you have diabetes.
* Change into a hospital gown and lie down on a special X-ray table.
* Meet with your provider to review instructions, questions and your medical history.

What to expect during angiography

During an angiogram procedure, your provider will:

1) Numb the area where the catheter will go.
2) Access your blood vessel with a needle.
3) Thread a wire through the needle.
4) Slide a long, slender tube called a catheter over the needle and into a large artery (usually in your groin or wrist area).
5) Slowly and carefully thread the catheter through your artery until the catheter’s tip reaches the part of the blood vessel they want to examine.
6) Inject a small amount of contrast material (dye) through the catheter and into your blood vessel segment. For a few seconds, this can make you feel flushed or like you need to pee.
7) Take X-rays.
8) Watch where the contrast agent goes on the X-ray monitor to see where and how well blood is moving in your blood vessels.

How long does an angiogram take?

An angiogram can take as little as 15 minutes. But some can take a few hours. It depends on what procedures your provider does after they find the issue.

If your provider finds a blockage, they may treat it right away with an angioplasty. This procedure uses a tiny balloon to force the blockage against your artery wall. An angioplasty may be all you need if it makes your blood flow better and there’s less than 30% of your blockage left after the procedure.

If an angioplasty doesn’t create a large enough opening for blood to get through, you may need a stent. This tiny metal tube stays in your blood vessel to keep it open. Your provider can place this right after your angioplasty.

Another treatment, surgery for your heart (coronary artery bypass) or legs (peripheral artery bypass), creates a way around your blockage. A provider will do this on a different day.

What to expect after angiography

Your healthcare provider will take out the catheter and bandage the area where they punctured your skin. They’ll press on the bandaged area for at least 15 minutes to stop or prevent bleeding.

If they put the catheter in through your leg, you’ll need to rest in bed for four to six hours. This will make your incision less likely to bleed.

Your provider will evaluate you and discuss at-home instructions with you before you go home.

Angiogram recovery

You should be able to go home the same day as your angiogram procedure or the next day, even if you had angioplasty and stenting. Because you received anesthesia, you’ll need someone to drive you home.

After you get home, don’t lift anything heavier than 10 pounds or stoop or bend for the next two days. This should keep your incision from bleeding.

A responsible adult should stay with you overnight after your procedure. Some people may need to spend the night in the hospital for their angiogram recovery.

If you have diabetes, don’t take metformin for 48 hours after the test. This reduces the risk of kidney complications.

Drinking water will help flush the contrast dye out of your system.

What are the risks of angiography?

Angiogram risks are low. But you can have complications in the area where your provider went through your skin to reach your artery. Angiogram complications happen in less than 1% of cases.

Risks of an angiogram procedure usually involve your puncture site and include:

* Bruises, which are 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
* Abnormal heart rhythm (arrhythmia) or cardiac arrest that requires resuscitation
* A blood vessel blockage from a blood clot that could cause a heart attack or stroke (rarely)
* A blood vessel leak (rarely).

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Angiogram

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