Angiography

Angiography: Purpose, Types, and Procedure

The process ‘angiogram’ refers to an imaging test that needs X-rays to view the blood vessels within your body. The X-rays obtained during angiography, known as angiograms, detect shrank, obstructed, enlarged, or abnormal arteries or veins in several body parts, including the brain, heart, abdomen, and legs. 

This medical procedure is known as angiography, which is usually used to anticipate blood flow in the body. It also provides a chance to intervene and handle blockages and other deformities, particularly those afflict the heart and brain. 

Purpose of Angiography:

Angiography is a procedure that involves injecting opaque materials into the bloodstream to view the pathway of blood vessels. As a rule, angiography does not pose a high threat, and the advantages for the patient typically outweigh the risks. 

Angiograms help find blockages in the lungs (pulmonary), heart (coronary), brain (cerebral), and tiny blood vessels (microangiography). Additionally, it may be helpful to diagnose inner bleeding, such as hemorrhage, and aneurysms (an unusual enlargement of the blood vessels), which may become the reason for severe upcoming health concerns.

Angiography allows your doctor to notice abnormal blood circulation caused by narrowed blood vessels (called stenosis), issues with the heart’s structure, inner bleeding, or other hindrance that should be taken out immediately. Unusual blood circulation can affect organs supplied by blood vessels and boost the risk of chest pain (angina), heart attack, stroke, and other illnesses.

In addition to its apparent diagnostic function, angiography may also be employed for treatment purposes. A procedure such as angioplasty may be required to remove obstructions and widen shrunk arteries. However, an angiogram can be used to expand fixed dilators called stents to dilate arteries and coil or seal off aneurysms.

Kinds of Angiography:

There are various kinds of angiography, reliant on the part of the body that is being examined. The most usual types are: 

  • Coronary angiography – is used to inspect the heart and blood vessels. 
  • Cerebral angiography – look at the blood vessels in and around the brain.
  • Pulmonary angiography – evaluate the blood vessels that supply the lungs.
  • Renal angiography- checks the blood vessels supplying the renals.

Angiography may sometimes utilize scans rather than X-rays, such as CT angiography or MRI angiography. Another type of fluorescein angiography is used to check the eyes. A detailed explanation of angiography types is given below;

  • Coronary angiography:

Coronary angiography is an X-ray method used to evaluate your heart’s blood vessels and to determine the presence of any obstruction in blood circulation. 

Coronary angiograms involve injecting dye into the blood vessels of your heart that can be seen using an X-ray machine. An X-ray machine quickly produces a series of pictures (angiograms) that reveal information about the blood vessels in your body. Your doctor can perform coronary angioplasty to open clogged arteries in the heart during your coronary angiogram.

  • Pulmonary angiography:

Angiography of the lungs utilizes X-rays to examine the vessels supplying blood to and from the lungs. It also aims to detect blood clots in the artery that connects your heart to your lungs. This is also called a pulmonary embolism. Under X-rays, a special dye gives your blood vessels a bright white appearance. The contrast allows doctors to see blood clots and other blood vessel conditions. 

  • Cerebral angiogram:

The purpose of cerebral angiography is to inspect blood vessels in the brain using a catheter, x-ray guidance, and an insertion of contrast substances to detect abnormalities like aneurysms or disease. A catheter enables the combination of detection and treatment in a single method. Angiograms of the brain provide very detailed, clear, and accurate images of blood vessels and may remove the requirement for surgery. 

  • Renal Angiography:

Renal angiography is an imaging test used to evaluate the blood vessels in the renals. A doctor may use this test to detect a ballooning blood vessel (aneurysm), shrinking of a blood vessel (stenosis), or obstructions in a blood vessel. This test can also assess the flow of blood to the kidneys. 

The radiologist inserts a contrast dye into the artery supplying blood to the renal during the procedure. After this, the doctor will use X-ray pictures to observe how the dye travels through the renal’s blood vessels. X

Preparations for Angiography:

You may require to visit the hospital for a consultation to determine whether or not an angiography is appropriate for you. It may involve the following: 

  • You may need to provide information about your medical record, including if you are allergic to anything.
  • The doctor will ask if you are already taking any medicine – if so, you must stop taking it before the examination.
  • The doctor may require inspecting your health, including physical and blood tests.
  • The doctor may discuss the angiography procedure with you, including what it is, the danger, what you require to do before the angiography, and even if you want to have a tranquilizer on the day of the test to aid you in staying calm.

It is recommended to refrain from eating or drinking anything for four to eight hours before anesthesia. 

During Angiography:

Here are the instructions for the angiography procedure:

  • In most cases, you’ll be awake, but a normal anesthetic might use for youngsters.
  • A tiny cut made in the skin over one of your arteries, normally near your wrist or groin – a local anesthetic is needed to daze the area so it won’t hurt.
  • A long, narrow, malleable tube is injected into an artery and skillfully guided to the targeted location during this procedure. 
  • A specific dye inserts through the tube-you may sense hot, flushed, and need to urinate. 
  • As the dye circulates through your blood vessels, X-rays are obtained.

Occasionally, treatment is performed simultaneously, like injecting a balloon or a tiny tube to widen a shrunk artery. The procedure is called angioplasty. Upon completing the procedure, the tube is detached, and stress is applied to the cut to prevent bleeding. The patient does not require stitches. 

After the angiography:

After the angiography, you will be taken to the ward to take some rest for a few hours to avoid bleeding. Usually, you will be able to return home on the same day, while sometimes, you will require to spend the whole night in the hospital to avoid any complications. 

Complications:

 

Most individual who undergoes an angiography do not experience complications, but there is a slight probability of developing a minor or more severe complication. Among the minor complications that may occur are:

  • There is an infection at the cut site, causing it to become red, hot, inflamed, and distressful- that may require antibiotic treatment.
  • There is a mild reaction to the dye, like an itchy rash, which can be handled with medicines.

The following serious complications are:

  • The dye may cause the temporary kidney to fail.
  • Heart attack.
  • An injury to a blood vessel may result in internal bleeding, which may require further surgery.
  • Anaphylaxis is a severe allergic reaction to the dye, characterized by dizziness, breathing problems, or loss of senses.

 

References: 

  • https://www.verywellhealth.com/angiography-4801242 retrieved on April 14, 2022.
  • https://www.mayoclinic.org/tests-procedures/coronary-angiogram/about/pac-20384904#:~:text=A%20coronary%20angiogram%20is%20a,as%20heart%20(cardiac)%20catheterizations retrieved on April 14, 2022.
  • https://www.nhs.uk/conditions/angiography/ retrieved on April 14, 2022.

https://www.webmd.com/lung/what-is-pulmonary-angiography retrieved on April 14, 2022.

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