Angiography

Overview -

Angiography is a prominent procedure that allows doctors to see how blood flows throughout the body. It may be necessary to diagnose a variety of medical issues. It also allows for intervention and treatment of blockages and other problems, particularly those affecting the heart and brain. Find out why it's done, how it's done, the risks and side effects, and how long it takes to recover from angiography.

Why it's done -

The X-ray imaging of blood flow in the body is known as angiography. During an angiography, X-ray-opaque chemicals are injected into the bloodstream. The path they take through blood arteries can be used to diagnose problems. Angiography is generally not seen as a high-risk operation, and the benefits for those who are requested to undergo it are usually substantial.

Angiography is used to find blockages in the lungs, heart, brain, and other smaller blood arteries (called microangiography). It could also be used to locate internal bleeding (haemorrhage) and aneurysms (abnormal dilatation of blood vessels), both of which can cause serious health problems.

Angiography allows your healthcare professional to see aberrant blood flow caused by stenosis (narrowing of blood arteries), heart structural abnormalities, internal bleeding, or other obstacles that need to be addressed. The organs fed by the vessels are affected by abnormal blood flow, which can raise the risk of chest pain (angina), heart attack, stroke, and other complications.

Angiography can be utilized for more than just diagnosis. It can also be used to give treatment. Angioplasty, for example, can be used to clear blockages and widen restricted arteries. As part of an angiography technique, fixed dilators called stents can be used to expand arteries and coil or seal aneurysms.

Types of Angiography -

Coronary Angiography

The coronary arteries are crucial to the heart's function because they deliver blood to it. Heart tests may be abnormal and particular symptoms may be present if certain vessels are restricted or obstructed, including:

• Chest pain (angina)

• Change in heart rate

• Change in blood pressure

• Unexplained pain affecting the jaw, neck, or arm

Serious medical problems, such as abnormal heart rhythms (arrhythmia), heart attack (myocardial infarction), or congestive heart failure, may emerge as this progresses.

Other heart conditions that can be detected and treated using angiography include:

• Congenital heart defect

• Aortic stenosis

• Heart valve disease

• Chest injury

An angiography procedure may be used by a healthcare provider to acquire information for treatment. A coronary angiography can aid a healthcare clinician (usually an interventional cardiologist or radiologist) in determining the source of a problem, making a diagnosis, and determining the next steps in therapy, such as surgery, medication, or behavioral modifications.

Cerebral angiography can also be used to visualize the blood arteries that supply the brain. The approaches are similar, but there is clearly a longer road to travel via the circulatory system to reach these locations. To improve visualization, other imaging techniques may be used in conjunction with the surgery.

Cerebral angiography can be used to alleviate narrowing that causes transient ischemic episodes or increases the risk of stroke. It may be feasible to remove a clot and reverse symptoms like weakness, numbness, loss of speech, or vision problems in the hours following a stroke. Sealing off cerebral aneurysms, abnormal dilatation or bulging of blood vessels that are prone to rupture and subsequent haemorrhage is also feasible. 

Microangiography

Microangiography can be used to examine the tiny blood arteries that supply other organs, which is very useful when dealing with localized bleeding. Because quickly growing tumours are very vascular, it may also be effective in diagnosing and treating malignant tumours. Taking away the tumor's blood supply could be a useful supplementary treatment.

Before the Test -

Prior to the operation, the physician performing it will likely take a detailed medical history and perform a physical examination to better inform the patient about the angiogram's aim, risks, and advantages. This is a fantastic opportunity to ask any questions you may have.

Initial non-invasive testing may be inconclusive when symptoms or health concerns occur that are related to disturbed blood flow or blood vessel injury. EKGs, cardiac stress tests, and imaging with a CT scan, MRI, or echocardiogram may not show the origin of symptoms. For diagnosis, a healthcare provider may wish to employ a more advanced imaging procedure such as angiography.

After the Test -

It can be beneficial to have someone around the day after the surgery to monitor for any concerns that may arise. They may be required to assist in the preparation of food or the administration of medications. If a major problem arises, it may be important to contact your healthcare practitioner and seek immediate medical help.

The patient should not drink alcohol, smoke, or perform tasks that require coordination for 24 hours after the angiography (such as operating vehicles or heavy machinery). Exercise, sexual intercourse, and submersion in water (such as a bath or swimming pool) should be avoided for three days to avoid reopening the access incision and exacerbating the risk of side effects.

Procedure –

• During this procedure also known as coronary angiography, the patient is positioned on an x-ray table.

• Depending on the condition of the arteries, either the under arm or groin area will be disinfected and then numbed with an anesthetic.

• A long, narrow tube (catheter) is then inserted into a large artery (in either the upper leg or upper arm) and gently threaded up into the coronary arteries around the heart muscle.

Risk and complications -

Angiography, like any other medical technique, has the potential to induce adverse effects or consequences. If there are procedural errors, allergies, or other medical issues, this is more likely. Because major problems are uncommon (estimated at 2% in cardiac catheterization) and nearly never fatal, there are no specific risk factors that should prohibit someone from undergoing an angiography. Certain circumstances, on the other hand, may influence how you prepare for and carry out the surgery, thereby lowering your risk. Technological advancements have also reduced the risk of equipment-related mechanical damage and unfavorable physiological responses to drugs used for pain management and imaging.

Allergic reactions can arise as a result of a variety of drugs employed during the treatment, and asthma or the use of beta-adrenergic blockers increases the risk of a severe allergic reaction. During the process, the mechanical movements of the tools might cause difficulties including bleeding and clotting, which can lead to more significant consequences such as:

• Bleeding

  Bleeding is the loss of blood. It can be external, or outside the body, like when you get a cut or wound. It can also be internal, or inside the body, like when you have an injury to an internal organ

• Aneurysm

  An aneurysm is a ballooning at a weak spot in an artery wall. An aneurysm's walls can be thin enough to rupture. The illustration shows a woman with an unruptured aneurysm.

• Stroke

  Hypertension, diabetes, previous strokes, impaired kidney function, and emergency angiography all raise the risk of a stroke during the procedure. When thrombosis occurs near the catheter or plaque is loosened, an embolus can go to the brain. Stroke affects less than 1% of those who have risk factors.

• Heart Attack (Myocardial Infarction)

  A heart attack can happen during an angiography, but it only happens in around 0.2 percent of the time. 1 It is more likely to occur in operations that are longer and more complicated. 

• Death

  Angiography can, unfortunately, lead to death in rare instances. Recent heart attacks, left main coronary artery disease, aortic stenosis, older age, and poor kidney function are all major risk factors for death. Death occurs in less than 0.1 percent of angiograms, impacting one in every 1000 persons who undergo the operation, however it is more likely in those who have recognized risk factors.

  The procedure's risk is always balanced against the procedure's potential benefit, which is frequently quite significant.

Insurance Covered – Following insurances are covered for Angiography :

The average length of stay - entails 3 days in hospital & 1 weeks to fully recover. 

 Doctors who perform CABG bypass procedure: