Arteriography

Arteriogram

What is an arteriogram?

An arteriogram is an X-ray of the blood vessels called arteries. It is performed to evaluate various vascular conditions, such as an aneurysm (a bulging, weakened area in the wall of a blood vessel), stenosis (narrowing of a blood vessel), or blockages. Other names for this procedure are angiogram and arteriography.

Fluoroscopy is often used during an arteriogram. Fluoroscopy is the study of moving body structures--similar to an X-ray "movie." A continuous X-ray beam is passed through the body part being examined, and is transmitted to a TV-like monitor so that the body part and its motion can be seen in detail.

During an arteriogram, a dye is injected into an artery making the arteries visible on X-ray. Many arteries can be examined by an arteriogram, including the arterial systems of the legs, kidneys, brain, and heart.

The development and improvement of diagnostic procedures such as computed tomography (CT scan), ultrasound, and magnetic resonance imaging (MRI) have greatly expanded the diagnostic capabilities of the radiology department. An arteriogram may be performed in conjunction with another type of diagnostic procedure such as CT, MRI, or ultrasound, which provides greater detail to the doctor.

Why is an arteriogram performed?

An arteriogram may be performed to detect abnormalities of the blood vessels. Such abnormalities may include, but are not limited to, the following:

• Aneurysms

• Stenosis (narrowing) or vasospasm (a spasm of the blood vessel)

• Arteriovenous malformation (an abnormal connection between the arteries and veins)

• Thrombosis (a blood clot within a blood vessel) or occlusion (blockage of a blood vessel)

Other conditions that may be detected by an arteriogram include tumors, hemorrhage, inflammation, and the invasion of a tumor into the blood vessels. Arteriography may be used to deliver medications directly into tissue or an organ for treatment, such as clotting medication to the site of hemorrhage or cancer medication into a tumor.

An arteriogram may be recommended after a previous procedure, such as a CT scan, indicates the need for further information. Treatments may also be done during an arteriogram, such as dissolving a clot or placing a stent in a blood vessel.

How is an arteriogram performed?

In order to obtain an X-ray image of a blood vessel, an intravenous (IV) access is necessary so that a contrast dye can be injected into the body's circulatory system. The contrast dye causes the blood vessels to appear opaque on the X-ray image. This allows the doctor to better visualize the structure of the vessel(s) under examination. When the dye is injected into specific blood vessels in order to examine a particular area of circulation more closely, the procedure is referred to as superselective angiography.

Generally, an arteriogram is performed under local anesthesia (numbing the site where the catheter is to be inserted), often accompanied by light sedation. However, the type of procedure to be performed and the part of the body involved may require general anesthesia (the person will be asleep during the procedure). Certain patients, such as infants and young children, or patients who are confused or extremely anxious, may also require general anesthesia.

The specific procedure for an arteriogram will depend on the body part or system being studied. Although each facility may have specific protocols in place, generally, an arteriogram procedure follows this process:

1. The patient will be positioned on the X-ray table.

2. An intravenous line will be inserted, generally into a vein in the patient's arm or hand.

3. The patient will be connected to an electrocardiogram (ECG) monitor that records the electrical activity of the heart and monitors the heart during the procedure using small, adhesive, electrode patches. Vital signs (heart rate, blood pressure, and breathing rate) will be monitored during the procedure.

4. A small incision will be made in the arm or groin, into which a small catheter will be inserted.

5. The catheter will be threaded into the desired artery.

6. Once the catheter is in place, an injection of contrast dye will be given into the catheter.

7. A series of X-rays will be taken.

8. Once the desired X-ray images have been obtained, the catheter will be removed and pressure will be applied over the area to keep the artery from bleeding.

9. In order to prevent bleeding from the catheter insertion site, the patient will remain flat in bed in a recovery room for several hours after the procedure.

10. Once at home, the patient should monitor the incision for bleeding, unusual pain, swelling, and abnormal discoloration or temperature change in the arm or leg on the side of the puncture site. A small bruise is normal. The patient may be advised not to do any strenuous activities for at least 72 hours, nor take a hot bath or shower until the next day.