Angiography

What is angiography?

Angiography is a specialised type of x-ray, using a Fluoroscopy machine, to examine blood vessels and internal organs as images of soft tissue cannot be captured using a normal x-ray.  It is generally a low risk, safe and relatively painless procedure, which produces high quality detailed images of arteries and veins and allows Specialists to treat diseased vessels.

Angiography is performed by inserting thin, spaghetti-like tubes called catheters, into an artery either in the groin or arm. By injecting an x-ray dye, called Contrast Media, into an artery or vein, imaging of the vessels´ course and flow can be achieved.

What part of the body is examined during angiography?

Angiography is typically performed to monitor the health of circulatory systems in the following parts of the body:

• Heart (coronary angiography)
• Brain (cerebral angiography)
• Lungs (pulmonary angiography)
• Kidneys (renal angiography)
• Gut (mesenteric angiography)
• Arms and legs (peripheral angiography)

What conditions can be diagnosed by an angiography?

Angiography can be used to diagnose a number of conditions which affect blood flow and cause damage to the blood vessels. For example:

• Atherosclerosis, causing narrowing of arteries called stenosis, affecting
  • Heart
  • Legs
  • Brain
  • Blood clots
  • Internal bleeding
  • Aneurysms, or ´ballooning´ of arteries

What are the risks and complications of angiography?

There are a few risks associated with angiographies.

For example, there is a very minor risk that patients may suffer from a severe reaction to the contrast medium and experience:

• Low blood pressure
• Anaphylaxis (severe allergic response)
• Cardiac Arrest

Allergic reactions to the Contrast Media are usually mild and can be treated immediately with medication.

This procedure uses x-rays, a form of radiation, to produce the required images. At high doses x-rays are known to increase the risk of cancer and cause localised skin changes to the area being imaged. During an angiogram great care is taken to reduce the radiation dose to a patient and maintain levels below an acceptable limit. In the case of complex and long procedures higher radiation doses are only accepted if the benefit to the patient is to outweigh the possible risks.

About the equipment

Angiography is performed using a Fluoroscopy Machine. This is a specialised x-ray device capable of producing low dose radiation images at a variable frame rate to produce seemingly ´live´ images. This allows doctors to place catheters into different arteries and produce highly detailed images of the desired vessels.

Preparation for an angiography

You will be given detailed instructions of how to prepare for your procedure when you book your appointment. This may involve ceasing certain medications and having a blood test.

You will need to tell the radiographer if you are:

• Pregnant
• Suffering from any serious health conditions or allergies (i.e. diabetes or kidney disease)
• Taking any medication

What to bring for an angiogram

Your GP or specialist may ask you to bring along any medications or copies of previous x-rays you have. Everything else needed will be supplied by the radiographer.

What to wear for an angiogram

You will be asked to remove any metallic items, such as jewellery, watches, eyewear and belts, as these items can show up on the x-ray.

You will be asked to remove any clothing obstructing the area to be x-rayed and given a medical gown to wear instead, so you should try and wear something that is comfortable and easy to remove.

How long will an angiogram take?

The exact timing of an angiogram will vary depending on the type of procedure and can take between 30 mins and 3 hours to complete.

Post angiogram instructions

After the procedure you will need a few hours of rest, to allow the effects of the anaesthetic to start to wear off and to prevent any bleeding from the catheter insertion.

Some patients may be asked to stay in hospital overnight for observation, but most will be able to go home after a couple of hours.

You will need a friend or family to stay with you as it usually takes eight to twelve hours before patients feel healthy enough to resume normal activities.

Can I drive home?

You will need someone to pick you up from the hospital as there will be an increased risk of bleeding from the catheter site for many hours. Patients should also abstain from any alcohol or the operation of any machinery for at least twenty-four hours after the procedure.

Resources

Diagnostic Imaging Pathways. (2013). Information for Consumers: Angiography (Angiogram). In Imaging Procedures. Retrieved from http://www.imagingpathways.health.wa.gov.au

Healthcare Imaging Service. (2016). Angiography. In Services. Retrieved from http://www.healthcareimaging.com.au

NHS Choices. (26 January, 2015). Angiography. In Health A-Z. Retrieved from http://www.nhs.uk/conditions