An angiogram is a radiological examination that can be both diagnostic and therapeutic. An angiogram is able to detect blockages using x-rays taken during the injection on an iodine-based contrast medium.
On clinical diagnosis, an angiogram using angiography may be indicated if the patient presents with symptoms of coronary heart disease (CHD), chest pain, or if the patient has suffered a previous heart attack. An angiogram is also useful in diagnosing various illnesses by providing detailed images of arteries inside the patient’s brain, heart and kidneys, and can expose aneurysms, tumors and myocardial infarction.
An angiogram is frequently performed with the patient under sedation. A small incision is made in the skin over one of the arteries, usually on the wrist or groin depending on the patient’s requirements. The attending radiologist or medical team then inserts a catheter (thing flexible tube) into the given artery and this is gently threaded through to the area under examination. Contrast solution (usually iodine based) is injected through the catheter and this will travel through the artery. If sedation has not been administered, the patient may feel a “hot flush” when the contrast is injected, but this only lasts for a few seconds.
A series of X-rays are taken in quick succession as the contrast (dye) flows through the blood vessels. Contrast is used to highlight the blood vessels on the x-ray. Images of the patient’s arteries will appear on a screen. The X-ray camera may be moved around in order to create a three dimensional representation, highlighting in detail where the constrictions or blockages may be.
Angiogram video is referred to as cine.This captures a video loop of the contrast as it flows through the vessels.
The medical team will then determine whether additional procedures need to be administered, including a balloon angioplasty or stent placement to open up a narrowed artery.
Angiograms are relied on to provide the best images of the arteries, as well as to make a specific diagnosis, and in this way help to determine the most conclusive treatment plan for the patient.
One of the most common procedures performed are coronary angiograms. This is commonly used to determine the severity of atherosclerosis in the arteries of the heart that may cause blockages. Partly blocked arteries can result in ischemia (lack of oxygen getting to the heart muscle). This causes cardiac chest pain. Complete blockages can cause a heart attack (myocardial infarction). This blocks the flow of blood and oxygen to the heart muscle and may cause the heart tissue to die.
Angiograms of the brain are used to diagnose stroke. Angiograms also can determine if a stoke is hemorrhagic or ischemic, which is important because that will determine the treatment.
Angiographic imaging is also used to guide percutaneous coronary interventions (PCI) to clear atherosclerotic blockages, often by using stents. The imaging technique is also used to guide numerous types of interventional radiology and vascular surgery procedures, include tumor embolizations, endovascular aortic repair (EVAR) and peripheral artery disease (PAD) interventions.
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