How angiography is performed
Depending on the complexity of the investigation, angiography takes between 20 and 90 minutes. You will usually be allowed to go home on the same day, although in some cases you may need to stay in hospital overnight.
Angiography is usually a planned procedure. However, it may occasionally be done on an emergency basis – for example, in the case of a Heart attack
Why It Is Done
An angiogram is done to:
1-Detect problems with blood vessels that affect blood flow. Examples of such problems include a tear in a blood vessel (which can cause blockage or internal bleeding), aneurysms (which are weaknesses in the blood vessel wall), and narrowed areas.
2-Look for changes in the blood vessels of injured or damaged organs.
3-Show the pattern of blood flow to a tumor. This can not only help show how much the tumor camera.gif has spread but also guide treatment.
4-Show the condition, number, and location of renal arteries camera.gif before a kidney transplant.
5-Look for a source of bleeding, such as an ulcer.
6-Prepare for surgery on diseased blood vessels of the legs (peripheral arterial disease) in people who have severe leg pain when walking.
7-Check how bad atherosclerosis is in the coronary arteries.
In some cases, a method called interventional radiology may be used during an angiogram to treat diseases. For example, a catheter can be used to open a blocked blood vessel, deliver medicine to a tumor, or stop intestinal bleeding caused by diverticular hemorrhage. To stop intestinal bleeding, the catheter is moved into the small artery where the bleeding is occurring, and medicine that narrows the artery or causes the blood to clot is injected through the catheter.
Types of Angiography
Coronary angiography (an-jee-OG-rah-fee) is a test that uses dye and special x rays to show the insides of your coronary arteries. The coronary arteries supply oxygen-rich blood to your heart.
A waxy substance called plaque (plak) can build up inside the coronary arteries. The buildup of plaque in the coronary arteries is called coronary heart disease (CHD).
Over time, plaque can harden or rupture (break open). Hardened plaque narrows the coronary arteries and reduces the flow of oxygen-rich blood to the heart. This can cause chest pain or discomfort called angina (an-JI-nuh or AN-juh-nuh).
If the plaque ruptures, a blood clot can form on its surface. A large blood clot can mostly or completely block blood flow through a coronary artery. This is the most common cause of a heart attack. Over time, ruptured plaque also hardens and narrows the coronary arteries.
How the Test is Performed
Coronary angiography is often done along with cardiac catheterization.
Before the test starts, you will be given a mild sedative to help you relax.
An area of your body (the arm or groin) is cleaned and numbed with a local numbing medicine (anesthetic). The cardiologist passes a thin hollow tube, called a catheter, through an artery and carefully moves it up into the heart. X-ray images help the doctor position the catheter.
Once the catheter is in place, dye (contrast material) is injected into the catheter. X-ray images are taken to see how the dye moves through the artery. The dye helps highlight any blockages in blood flow.
The procedure may last 30 to 60 minutes.
How to Prepare for the Test
You should not eat or drink anything for 8 hours before the test starts. You may need to stay in the hospital the night before the test. Otherwise, you will check in to the hospital the morning of the test.
You will wear a hospital gown. You must sign a consent form before the test. Your health care provider will explain the procedure and its risks.
Tell your doctor if you are allergic to seafood, if you have had a bad reaction to contrast material in the past, if you are taking Viagra, or if you might be pregnant.
How the Test will Feel
In most cases, you will be awake during the test. You may feel some pressure at the site where the catheter is placed.
You may feel a flushing or warm sensation after the dye is injected.
After the test, the catheter is removed. You might feel a firm pressure being applied at the insertion site to prevent bleeding. If the catheter is placed in your groin, you will be asked to lie flat on your back for a few hours to several hours after the test to avoid bleeding. This may cause some mild back discomfort.
There is a normal supply of blood to the heart and no blockages.
What Abnormal Results Mean
An abnormal result may mean you have a blocked artery. The test can show how many coronary arteries are blocked, where they are blocked, and the severity of the blockages.
Cardiac catheterization carries a slightly increased risk when compared with other heart tests. However, the test is very safe when performed by an experienced team.
Generally the risk of serious complications ranges from 1 in 1,000 to 1 in 500. Risks of the procedure include the following:
Injury to a heart artery
Low blood pressure
Allergic reaction to contrast dye
Considerations associated with any type of catheterization include the following:
In general, there is a risk of bleeding, infection, and pain at the IV site.
There is always a very small risk that the soft plastic catheters could damage the blood vessels.
Blood clots could form on the catheters and later block blood vessels elsewhere in the body.
The contrast dye could damage the kidneys (particularly in patients with diabetes).
CT coronary angiogram