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Interventional Radiology (Angiography)
Interventional radiology is a minimally-invasive medical test that helps physicians diagnose and treat medical conditions. Interventional radiology uses one of three imaging technologies and in some cases a contrast material to produce pictures of major blood vessels throughout the body.
Interventional radiology is performed using x-rays with catheters. A catheter is a thin plastic tube inserted into an artery through a small incision in the skin. The catheter is a long plastic tube about as thick as a strand of spaghetti. Once the catheter is guided to the area being examined, a contrast material is injected through the tube and images are captured using a small dose of x-rays.
Why is this procedure conducted?
Interventional radiology is used to examine blood vessels and other structures in key areas of the body, including the brain, kidneys, pelvis, legs, lungs, heart, neck, and abdomen.
Why is the Procedure Performed?
- To identify disease and aneurysms in the aorta, both in the chest and abdomen, or in other major blood vessels
- To detect atherosclerosis (plaque) disease in the carotid artery of the neck, which may limit blood flow to the brain and cause a stroke
- To identify a small aneurysm or arterio-venous malformation inside the brain
- To detect atherosclerotic disease that has narrowed the arteries to the legs and help prepare for endovascular intervention or surgery
- To indicate disease in the renal artery or visualize blood flow to help prepare for a kidney transplant
- To guide surgeons making repairs to diseased blood vessels, such as implanting or evaluating a stent
- To detect injury to one of more arteries in the neck, chest, abdomen, pelvis or extremities in trauma patients
- To evaluate the details of arteries feeding a tumor prior to surgery or other procedures such as chemoembolization or selective internal radiation therapy
- To identify dissection or splitting in the aorta in the chest or abdomen or its major branches
- To show the extent and severity of atherosclerosis in the coronary arteries
- To plan for a surgical operation, such as coronary bypass
- To sample blood from specific veins in the body to detect any endocrine disease
- To examine pulmonary arteries in the lungs to detect pulmonary embolism (blood clots from leg veins)
How do I prepare for the exam?
You should inform your physician of any medications you are taking and if you have any allergies, especially to iodinated contrast materials. Also inform your doctor about recent illnesses or other medical conditions.
You may be asked to remove some or all of your clothes and to wear a gown during the exam. You may also be asked to remove jewelry, eye glasses and any metal objects or clothing that might interfere with the x-ray images.
If you are breastfeeding at the time of the exam, you should ask your radiologist how to proceed. It may help to pump breast milk ahead of time and keep it on hand for use after contrast material has cleared from your body, about 24 hours after the test.
If you are going to be given a sedative during the procedure, you may be asked not to eat or drink anything for four to eight hours before your exam. Be sure that you have clear instructions from your health care facility.
If you are sedated, you should not drive for 24 hours after for your exam and you should arrange for someone to drive you home. Because an observation period is necessary following the exam, you may be admitted to the hospital for an overnight stay if you live more than an hour away. Please see specific exams for pre and post procedure instructions.
What type of equipment is used?
The equipment typically used for this examination consists of a radiographic table, an x-ray tube and a television-like monitor that is located in the examining room or in a nearby room. When used for viewing images in real time (called fluoroscopy), the image intensifier (which converts x-rays into a video image) is suspended over a table on which the patient lies. When used for taking still pictures, the image is captured either electronically or on film.
The catheter used in angiography is a long plastic tube about as thick as a strand of spaghetti.
How is the procedure performed?
This examination is usually done on an outpatient basis.
A nurse or technologist will insert an intravenous (IV) line into a small vein in your hand or arm.
A small amount of blood will be drawn before starting the procedure to make sure that your kidneys are working and that your blood will clot normally. A small dose of sedative may be given through the IV line to lessen your anxiety during the procedure.
You may also be placed on a monitor so that the nurse can watch your vital signs during the exam.
The area where the catheter will be inserted is shaved, cleaned, and numbed with local anesthetic. The radiologist will make a small incision (usually a few millimeters) in the skin where the catheter can be inserted into an artery. The catheter is then guided through the arteries to the area to be examined. After the contrast material is injected through the catheter and reaches the blood vessels being studied, several sets of x-rays are taken. Then the catheter is removed and the incision site is closed by placing pressure on the area for approximately 10 minutes (or by using a special closure device).
A catheter angiogram may be performed in less than an hour; however, it may last several hours.
What can I expect during the exam?
Prior to beginning the procedure, you will be asked to empty your bladder.
You will feel a slight pin prick when the needle is inserted into your vein for the intravenous line (IV).
Injecting a local anesthetic at the site where the catheter is inserted may sting briefly, but it will make the rest of the procedure pain-free.
You will not feel the catheter in your artery, but when the contrast material is injected, you may have a feeling of warmth or a slight burning sensation. The most difficult part of the procedure may be lying flat for several hours. During this time, you should inform the nurse if you notice any bleeding, swelling or pain at the site where the catheter entered the skin.
You may resume your normal diet immediately after the exam. You will be able to resume all other normal activities 8 to 12 hours after the exam.
What can I expect after the exam?
A radiologist, a physician specifically trained to supervise and interpret radiology examinations, will analyze the images and send a signed report to your primary care or referring physician, who will discuss the results with you.