Normal carotid
arteriogram.
Carotid arteriogram
demonstrating
carotid artery
stenosis (arrow).
Normal frontal
cerebral arteriogram
Cerebral arteriogram
demonstrating
a
large aneurysm
arising from
the left internal
carotid artery
(in the brain).
Normal pelvic
angiogram.
Normal renal
angiogram. |
The list of treatments and
tests that can be performed by the interventionalist continues to grow
and now includes the removal of tissue samples from the liver, lungs, and
other vital organs; drainage of fluid from the chest, abdomen, or kidneys;
and removal of gallstones and kidney stones. By injecting beads, coils,
or other materials through catheters, radiologists can cause the intentional
blocking of arteries that are bleeding or supplying nutrients to life-threatening
cancers or tumors.
Interventional radiology offers an alternative
to the surgical treatment of many conditions. It results in significant
reductions in the risk, pain, and recovery time compared to traditional
surgical treatments. Because it is less invasive, it is generally safer,
less costly, and faster than surgery, and results in a significantly reduced
hospital stay. This is important for the stronger patient and can be a
matter of life and death to a very weak patient who could not survive the
trauma of a surgical procedure.
Preparing for an Arteriogram
Prior to the arteriogram, your doctor will
talk with you about your medical history, including any past health problems,
medications you are taking, and allergies you may have. You should not
drink or eat anything for a few hours before the test is scheduled. You
will need to remove all your jewelry prior to the test, and you will be
asked to put on a hospital gown. Also, you should make sure you go to the
bathroom before the procedure.
Interventional radiology involves the treatment
of the patient, rather than just the diagnosis of the disease. The Society
of Cardiovascular and Interventional Radiology describes Interventional
Radiology as a specialty within radiology "in which specially trained physicians
use x-rays and other imaging techniques to see inside the body while they
guide narrow tubes (catheters) and other small instruments through the
blood vessels and other pathways in the body to the site of a problem,
treating a variety of medical disorders without surgery."
One of the most dramatic applications of
the interventionalist's art is in the treatment of patients suffering from
blockages in arteries. If blood vessels become totally blocked they can
cause loss of function of the tissue or even death of the organ or limb.
To increase blood flow, the interventionalist
can insert a catheter into a blood vessel and thread it to the point of
the narrowing or blockage, then inflate a tiny balloon on the end of the
catheter (angioplasty). Using angioplasty, the radiologist can open the
blockage and return normal blood flow to the tissue. Other techniques are
available to open blocked vessels, including the use of stents to hold
arteries open from the inside. These stents stay in the vessel permanently.
The effect of these treatments is dramatic and immediate, and the need
for subsequent surgery is often eliminated.
These techniques are frequently used to
open narrowed or blocked leg arteries, which cause pain during exercise
(claudication), and to treat narrowed arteries to the kidneys, which can
cause renal failure or high blood pressure.
What to Expect During an Arteriogram
You will need to have an intravenous line
placed prior to the test, and a catheter, a thin hollow tube, will be inserted
into an artery. The area where the catheter is placed will be shaved and
cleaned. You will be given a local anesthetic before a small incision is
made in your skin and the catheter inserted. The catheter is guided by
the radiologist to the area of the body that needs to be visualized.
Once the catheter is in place, a contrast agent is injected. This may cause
you to feel a warm flush for a short period of time.
Images of the arteries are recorded for
evaluation. The arteriogram usually takes 60 to 90 minutes.
After the test is completed, the catheter
is removed and pressure is applied to the artery to stop any bleeding.
An ice bag may also be placed over the area of the incision. You will be
taken back to your hospital room and will need to stay there for several
hours. Your doctor or nurse will tell you when you can get out of bed. |
Angiography
is an x-ray study of the arteries. This procedure involves injecting a
contrast material (x-ray dye) into a blood vessel to make it visible on
an x-ray. The dye is placed directly in the artery through a very small
flexible tube called a catheter, which is inserted in to the artery through
a small nick in the skin.