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Angiography
Date 16/09/11/01/31  Author Divya  Hits 886  Language Global
Introduction

Arteriography is a medical imaging technique used to visualize the blood vessels, organs of the body with particular interest in arteries, veins, and heart chambers. It is also called as Angiography.


Angiography is done to detect the blocks present in the branches of the heart. To explain in simple words, heart has three main branches and some small branches.

If the block is present on any one of the main branches then the block is said to be civier, in such cases the patient will be advised to undergo a bypass surgery, if the blocks are present on the small branches then patient can undergo a procedure called Angioplasty - a minor surgical procedure somewhat similar to the procedure of catheter Angiography. The film or image is called an Angiogram.


Types

Angiography is classified into several types as follows


Coronary Angiography

Procedure done to visualize the blood in the coronary arteries.

Micro AngiographyANGIOGRAPHYProcedure done to visualize tiny blood vessels.

Neuro-Vasular Angiography

Procedure done to visualize the arterial and venous supply to the brain.

Peripheral Angiography

Procedure done to identify narrow vessel and to find and repair stroke.


Technologies Used for Imaging

Angiography is performed using:

·         X-rays with catheters

·         Computed Tomography (CT)

·         Magnetic Resonance Imaging (MRI)


Catheter Angiography

This is a standard type of Angiography before all CT and MRI techniques that is been used nowadays for imaging. This has a major disadvantage, which is, it is more invasive than CT. This technique was particularly developed to diagnose heart blocks.

Procedure

v  The patient will be given anesthesia and made to lie on a narrow table.

v  The x-ray source and the imaging camera will be placed on the opposite side above the area of the patient to be examined.

v  A needle like catheter will be inserted into the body’s radial region (hand) or through the lower side of abdomen.

v  A dye will be injected through the catheter for the detailed examination of the organ.

v  By viewing through the camera the catheter can be made to reach the exact region that is to be examined

v  The computer workstation that processes the imaging information is located in a separate room. By which doctors can come to a conclusion whether to go for a surgery or any other treatment procedures.


CT Angiography

CT imaging uses special x-ray equipment to produce multiple images and a computer to join them together in multidimensional views, which is being used for diagnosis and treatment.


Procedure

The patient will lie on a narrow examination table that slides into and out of the tunnel as shown in the picture below, the tunnel will be rotating around, the x-ray tube and electronic x-ray detectors are located opposite to each other in a ring, called a gantry. The computer workstation that processes the imaging information is located in a separate room, where the technologist operates the scanner and monitors the patient’s examination.

First an intravenous (IV) catheter, also called a line, is inserted into a small vein usually in the arm or hand. . A small amount of dye may initially be injected through the IV to determine how long it will take for the full amount to reach the area under examination. Dye is a substance used to "highlight" an organ or tissue during examination. The table will then move to the start point and then move back through the opening in the machine as the actual CT scanning is performed. An automatic injection machine connected to the IV is usually used and will inject contrast material at a controlled rate both prior to and during scanning. This is how CT Angiography is performed.


Benefits

ü  Angiography may eliminate the need for surgery. If surgery remains necessary, it can be performed more accurately.CT Angiography may give more precise anatomical detail than magnetic resonance imaging(MRI), particularly in small blood vessels.

ü  Many patients can undergo CT Angiography instead of a conventionalcatheter angiogram (catheterization).

ü  Compared to catheter Angiography, which involves placing a catheter (plastic tube) and injecting contrast material into a large artery or vein, and may require general anesthesia, CT Angiography is a much less invasive and more patient-friendly procedure.

ü  There is also less discomfort because contrast material is injected into an arm vein rather than into a catheter inserted into a large artery or vein.

ü  No radiation remains in a patient's body after a CT examination.


Limitations

·         Person having overweight may not fit into CT.

·         Person having kidney disease, diabetes cannot undergo this procedure.


Precautions

Ø  Metal objects including jewelry, eyeglasses, dentures and hairpins may affect the images.

Ø  Should not eat or drink anything for several hours before the procedure as instructed by their own doctors.

Ø  If any history of heart disease, asthma, diabetes, kidney disease or thyroid problems should be informed to the doctor before the examination.

Ø  Any medications being taken by the patient or if any allergies should be informed to the doctor prior to the examination.

Ø  In case of known allergy to contrast material or "dye," the doctor may prescribe medications to reduce the risk of an allergic reaction.

Ø  Women should always inform their doctor and the CT technologist if there is any possibility that they are pregnant.


Conclusion

The procedure of Angiography may have some slight modifications depending on the type of Angiography. For example in exams of the coronary arteries or aorta in the chest, electrocardiogram (EKG) leads are usually placed to record heart rate and rhythm during scanning. Heart rate may be slowed with drugs given prior to scanning. If heart rate medication is given, then the patient will be monitored during and after the procedure. The Angiography is a very special diagnostic procedure, because this can produce an accurate result for the patient’s treatment whether to go for a surgery or not. 

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