ANGIOGRAPHY

Angiography is an x-ray technique in which a dye is injected into the blood vessels of different parts of the body like chest, head, legs, back etc. The resulting pictures are called angiograms.

An angiogram of the heart is known as coronary angiogram. It is the gold standard for the evaluation of coronary artery disease

TYPES OF ANGIOGRAM

Angiograms are used to diagnose narrowing or blockages in blood vessels anywhere in the body, from head to toe, including

  • Blood vessels of the heart-coronary angiography
  • Blood vessels of the brain-cerebral angiography
  • The arteries feeding the kidneys-renal angiography
  • Blood vessels of the lungs-pulmonary angiography

A magnetic resonance angiogram (MRA) or computed tomography angiogram (CTA) may be an option instead of an angiogram. Each of these tests is less invasive than a standard angiogram. Some MRA tests and all CTA tests require an injection of dye. A CTA also involves radiation exposure.

WHY IS IT DONE?

Angiography helps to diagnose or investigate a number of problems affecting the blood vessels, including:

  • Atherosclerosis– Detect problems with blood vessels that affect blood flow. Examples of such problems include a tear in a blood vessel, aneurysms, and narrowing of the arteries, which could mean you’re at risk of having a stroke or heart attack
  • Peripheral arterial disease– It is a circulatory condition in which narrowed blood vessels reduce blood supply to the leg muscles
  • Brain aneurysm– Shows the pattern of blood flow to a tumor. This can not only help show how much the tumor has spread but also guide treatment.
  • Kidney disease-Show the condition, number, and location of renal arteries before a kidney transplant
  • Angina chest pain that occurs when the blood supply to the heart muscle is restricted
  • Blood clots or a pulmonary embolism– a blockage in the artery supplying your lungs

PRE-OPERATIVE MEASURES: ANGIOGRAM

Before undergoing an angiogram, you may be asked to attend a hospital appointment to check that you can have the test.

This may involve:

  • To know about the medical history including if you have any allergies
  • Tell your doctor if you are taking any blood thinning medication
  • Physical examination and blood tests are done before angiogram
  • You should not eat or drink anything for 8 hours before the test starts

HOW IS A CORONARY ANGIOGRAM PERFORMED?

Angiography is carried out in a hospital X-ray or radiology department

  • A very thin flexible tube (catheter) is inserted into the artery in the groin or above elbow
  • The catheter is carefully guided to the area that’s being examined such as the heart
  • An iodine dye (contrast medium) is injected into the catheter to make the area show clearly on the X-ray pictures. This method is known as conventional or catheter angiogram
  • A series of X-rays are taken as the dye flows through your blood vessels during the procedure
  • The test can take between 30 minutes to two hours. You’ll usually be able to go home a few hours afterwards

POST-OPERATIVE MEASURES: ANGIOGRAM

  • After the test, you’ll be taken to a recovery ward to prevent bleeding from the cut
  • You’ll usually be able to go home the same day, although sometimes you may need to stay in hospital overnight
  • It may be possible to tell you the results of the test before you go home, but often the X-rays need to be studied in detail and the results are not available for a few weeks

FREQUENTLY ASKED QUESTIONS (FAQ’S)

Can children have an angiogram?

Most angiograms in children aim to treat a heart problem, as well as diagnose it. The angiogram is the same as for adults, but it’s usually done under a general anaesthesia. This is because children may find it difficult to stay still during the test. The staff at the hospital will take every step to take care of your child during the procedure.

Is an angiogram painful?

Angiograms aren’t usually painful. You usually have the procedure under a local anaesthesia. This means you don’t feel any pain where the catheter enters your artery. If you’re anxious or worried, you can have a sedative before the test. This will relieve anxiety and help you relax.

During the angiogram, if you notice any pain, tell the doctor or nurse, as they may give you some painkillers. When the dye is injected, you may notice a warm flushing sensation. You may have some soreness and bruising after the angiogram. This doesn’t usually need any treatment and disappears on its own.

Why do I stop taking blood thinning medicines before an angiogram?

Your doctor may ask you to stop taking blood thinners a few days before your angiogram. This will reduce your risk of bleeding during, and immediately after the procedure.

Consult with a doctor to know about the preparation before the test. If you take any medicines regularly, show them to your doctor so they know exactly what you’re taking.

Can I have an angiogram if I’m allergic to dyes?

Most often, antihistamines and steroids can be given as a pretreatment to patients with previous allergic reactions to the contrast dye. This pretreatment should suffice in bringing down the risk of an adverse reaction to a minimum.

Am I being exposed to too much radiation during this procedure?

Since this procedure has live x-ray imaging, patients will be exposed to a small amount of radiation. However, it is not very harmful at low levels.