Angiography (arteriography) | Definition, usage, purpose and how is the examination done


An arteriography or angiography is an x-ray examination of the arteries. This exam allows an optimal analysis of all arteries in the whole body. Arteries are the vessels that bring oxygenated blood to the organs of the body.

This examination technique accurately shows the diameter of the interior of the vessels and especially the presence of any narrowing or rupture of the artery. These strictures are usually due to the presence of atherosclerotic plaques. The organ or organs that depend on the diseased artery are affected by the lack of oxygen supply from the blood. For example, an affected coronary artery will cause angina pectoris or an injury to the femoral artery will cause pain in the calf. The arteriography will therefore make it possible to demonstrate and quantify the severity of the damage to the artery, which can in certain cases be directly treated by angioplasty (dilation of the artery by a balloon).

A venography is a direct examination of the veins that returns blood from the organs to the heart. All the veins in the body can also be examined by angiography. The veins can also be narrowed or compressed, or even blocked (thrombosis). As for arteriography, in some cases, an intervention (dilation or recanalization) may be offered and directly attempted.

The purpose to do angiography

Its purpose is to detect vascularization disorders. It can also be prescribed before an operation to pinpoint the path of the blood vessels.

What is angiography used for?

Angiography studies blood vessels that are not visible on standard x-rays. We talk about arteriography for the exploration of the arteries and phlebography for that of the veins.
This examination is very useful for the diagnosis of vascularization disorders or before a surgical intervention in order to precisely locate the course of the vessels.
At the arterial level, she looks for abnormalities such as strictures (strictures) or other obstacles to the flow of blood. We can explore the renal, pulmonary, cerebral arteries, of the retina, of the limbs …
A dilation of the vessel can be performed in the narrowed part: this is called angioplasty.
At the venous level, it is part of the phlebitis assessment (clot in a vein) and determines the consequences.

What is an angiogram?

This exam uses x-rays and an iodine-based contrast medium.
Its principle consists in making the arterial or venous vessels visible (or opaque). A catheter is introduced into the vessel to inject the contrast product which mixes with the blood: the vascular system becomes visible on X-rays thanks to the radiopaque properties of iodine.

The angiography room is made up of:

  • The device which consists of a tilting table above which an articulated arm with an X-ray tube moves.
  • The control console behind which the medical staff are located and which is separated from the rest of the room by a leaded glass.

Coronary angiogram

A coronary angiogram (also called a heart coronary angiogram) is a test that takes x-rays of the coronary arteries and the vessels that supply the heart. During this procedure, a special stain, or an iodine product, is injected into the coronary arteries from a catheter (long and narrow tube) inserted into a blood vessel; each of them then becomes visible on the x-ray. Angiography allows doctors to see blood flow through the heart separately, and sometimes even identify possible problems with the coronary arteries.

Coronary angiography may be recommended for people with angina (chest pain) or those with symptoms of coronary artery disease. It provides doctors with important information about the condition of the coronary arteries, which can be affected by atherosclerosis, regurgitation (blood pumped back through a damaged valve), or pooling of blood in a cavity, caused by a malfunction of a heart valve.

Read also: Heart diseases | List of cardiovascular diseases | Include pathologies that affect the heart and all of the blood vessels

What does the examination room look like?

An angiography room has a movable table on which you will be lying. This movable table will be moved under a large C-shaped articulated arm that contains an x-ray tube on one side (under the table) and a camera on the other (above you).

How does it work?

The arteries are demonstrated by injecting directly, through a small catheter, an iodinated contrast product into their lumen. During the injection of the iodine product, X-rays will be produced under the examination table and pass through your body. The contrast product is opaque to X-rays and the camera placed above you will simultaneously show us the injected arteries on a screen. The images obtained are computerized and stored. The movable arm around you can be moved to get different views of the same artery.

How is the test done?

From your bed, you will be placed on the examination table. Electrodes will be placed on your chest to record your heart’s activity throughout the part of the exam. The puncture site of the artery (normally the femoral artery) will be disinfected and a sterile drape will cover you. Local anesthesia is performed on the skin and surrounding tissue. The artery is punctured directly after anesthesia and an introducer is placed in the artery. A catheter will then be positioned on the areas of interest or introduced directly into the diseased artery. An iodinated contrast product will be injected by a pump through the catheter, directly into the artery chosen by the doctor. This product will cause a sensation of heat for a short time.

You will regularly be asked to stop breathing for a few seconds in order to get still, clear images. Once the images have been obtained, the doctor will communicate the result directly to you. If treatment is possible, the doctor will inform you immediately and after your agreement, the appropriate treatment is carried out.

Side effects

The side effects of angiography are related to the injection of the dye and depend on the type of angiogram performed. These side effects may include the following:

bleeding, infection and pain at the tube insertion site
dye reaction
kidney damage (very low risk)
damage to the blood vessels caused by the tube (very low risk)
blood clots on the tube, which could then block blood vessels elsewhere in the body.

What the results mean

Your doctor will explain the results of the angiogram to you and may recommend additional tests, procedures, follow-up or treatment.
Special considerations for children
Preparing a child for a test or procedure can reduce anxiety and increase collaboration, and help develop coping skills. Preparation includes explaining what will happen during the procedure, including what they will see, feel and hear.

Preparing a child for an angiogram depends on their age and experience.

Sumber bacaan: PinterPandai, Society for Vascular Surgery, British Heart Foundation

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