Angiography is an imaging procedure used to diagnose vascular diseases and corresponding injuries. This radiology procedure can be used to diagnose diseases of the veins and arteries, for example an aneurysm or peripheral arterial occlusive disease.
Below you will find further information and selected angiography specialists.
Angiography is an imaging procedure that provides information about the condition of the blood vessels. For this purpose, a blood vessel is punctured (i.e. pierced through the skin) and imaged using X-rays. A contrast agent is usually injected to improve the image. This makes it easier to see the blood vessels in the X-ray image.
Doctors can then analyze the image of the inside of the vessel, known as an angiogram, to make a diagnosis. An angiogram can
visualize.
Vascular diseases are the most common cause of death in Germany. For this reason, it is advisable to take precautions here. Basic blood and blood pressure checks are possible. If necessary, angiography can also help to examine the vessels using imaging techniques.
In this way, an aneurysm can be detected. This is a dangerous widening of the arteries, also known as an arterial bulge. If an aortic aneurysm bursts, for example, there is an acute danger to life.
Peripheral arterial occlusive disease(PAD) can also be diagnosed using angiography. It is commonly known as "intermittent claudication". In this case, an artery is narrowed or blocked.
To make the diagnosis possible, an appropriate contrast agent is injected during the examination. The agent is then distributed in the vascular system, which in turn can be visualized excellently.
The angiogram has proven to be efficient in the examination of vascular disorders and progressions.
However, many special features of the blood vessels can also be visualized by ultrasound examinations. An ultrasound examination is less risky and, in the case of large vessels, also very accurate. For this reason, they are often carried out before angiography.
If the results of the ultrasound are not clear and there are still unanswered questions, an angiography can follow.
Angiography shows the course and health of blood vessels very well © samunella | AdobeStock
In classic digital subtraction angiography (DSA), a vessel is punctured , usually in the groin. As a rule, the patient feels little or nothing of the examination. Only the injection of the contrast medium occasionally results in a general feeling of warmth.
The doctor then inserts a catheter, which is advanced into the target region. He then releases the contrast medium, which appears white on the subsequent images. The angiography device digitally subtracts images before and after the administration of contrast medium (= subtraction) . Afterwards, it only shows the contrast medium in the vessels and thus their position and course in detail.
This enables doctors to identify constrictions and occlusions very clearly.
If necessary, constrictions or blockages can then be treated during the same examination. A balloon catheter is used for this purpose, which is stabilized from the inside with a stent.
Once the catheter has been removed from the inguinal artery, the puncture site must be kept under pressure for approx. 10-15 minutes. The patient is then given a pressure bandage until the next day to prevent bleeding.
In CT or MR angiography, the contrast agent is injected via a vein in the arm. It is not necessary to puncture the artery.
The CT or MRI device then produces slice images that are digitally combined to form three-dimensional images.
Computed tomography (CT) is a form of X-ray examination, i.e. it works with radioactive radiation. A CT angiography only takes a few seconds.
In MR angiography, a magnetic resonance tomograph (MRT) is used for imaging. An MRI uses magnetic fields instead of radioactive radiation. There is therefore no radiation exposure. An MR angiography takes about 20 minutes.
The major advantage of these two special forms is that the risk of bleeding is very low, as no artery has to be punctured.
However, if constrictions are found, they cannot be treated at the same time as with classic DSA.
The three methods cannot be used equally for every patient.
MR examination is not possible, for example, if the patient has metal-containing implants or devices in the body, such as
The physician can then switch to CT angiography. Local anesthesia is usually sufficient.
MR angiography is recommended for
A different contrast agent is used here than for CT angiography or DSA. This does not contain iodine, which significantly reduces the risk of hyperthyroidism or allergic reactions.
Complications during angiography are generally rare, but a residual risk cannot be ruled out.
The four most common complications are
The puncture site is usually in the groin. Bleeding into the tissue can occur here. In extreme cases, this must be surgically stitched over, but it can often be treated or prevented by compression.
The patient must therefore remain lying still in bed after the examination. A pressure bandage is applied to the groin and left in place for 24 hours.
If you regularly take blood-thinning medication, you must inform your doctor. You may have to stop taking this medication before the examination.
It is also essential to have up-to-date laboratory values determined. This ensures that your body has sufficient blood coagulation.
Before using the iodine-containing contrast medium, the patient must be tested for intolerance. Allergic reactions to the contrast medium used are among the most common complications of angiography.
If an allergy is detected in advance, it is essential to take anti-allergic medication. Alternatively, MR angiography can be performed. No iodine-containing contrast medium is used.
The kidneys are responsible for excreting the contrast medium. They must be functionally capable of doing this. If problems with excretion are foreseeable, medication can help to improve kidney function for the procedure.
It is therefore essential to determine the kidney values by taking a blood sample. You should also drink enough before and after the examination, ideally mineral water. Infusion therapy may also be necessary.
Iodine increases the function of the thyroid glands. If the patient suffers from hyperthyroidism, the thyroid function may have to be reduced before the examination. Otherwise, a shock reaction may occur during and after the angiography.
MR angiography can also be avoided in such cases. It is therefore very important that functional disorders are known and reported before the examination.
Necessary tests before the procedure at a glance:
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