Kenneth W. Chin (M.D., F.A.C.R.) gives expert video advice on: How do I know which angiogram works best for me?; Is it safe to inject the contrast agent into the blood stream during an angiogram?; What are the benefits of angiography? and more...

What is 'angiography'?

Angiography is the imaging of blood vessels. This could be done in a number of ways. In the past, the only way we had for imaging the blood vessels in a radiology procedure was by placing a thin plastic tube into a blood vessel, injecting some iodine containing dye in taking a taking x-ray pictures. However what we currently have available to us are a number of different ways in which we take a look of those blood vessels which can include CT angiography and MR angiography or ultrasound using Doppler imaging.

How does a catheter angiogram work?

A catheter angiogram is performed when a thin plastic tube called a catheter is placed within a blood vessel then some contrast agent typically an iodine containing contrast agent or dye is injected into that blood vessel. That particular contrast material then travels with the blood stream and x-ray images are obtained.

How does an MR angiogram work?

MR angiography allows us to take a look at the blood vessels in a variety of different ways. One of which is the injection of a medication, which is called gadolinium, which then travels through the blood vessels. Using the MR techniques we can see those blood vessels. Alternatively, without an injection we can sometimes excite some of the atoms within the body that allows us to show blood flow.

How does a CT angiogram work?

CT angiogram is performed following the injection of an iodinated contrast agent into the veins of the body. And we watch the blood flow through the various blood vessels, depending on when that iodine dye reaches those blood vessels.

How do I know which angiogram works best for me?

In order to determine what the best type of angiography you might need, you should refer to your radiologist who, in consultation with your treating physician, will be able to determine which particular form of angiography would be the safest for you and will give you the answers that you need.

Is it safe to inject the contrast agent into the blood stream during an angiogram?

The injection of contrast material into the blood vessels during the angiogram is relatively safe; however, some patients can have problems because of allergies to the medication or if they have kidney disease.

When would angiography be used?

Angiography is used to look at blood vessels to see whether or not there are areas that are narrowed or blocked or enlarged. It is also useful in looking at the blood vessels of various organs that might be diseased. Whether they be involved with a cancer or an infectious process.

Is getting an angiogram painful?

The procedure of an angiogram is, by and large, painless. However, there are portions of the examinations, such as the initial introduction of the catheter, that may require the introduction of some local anesthetic to numb the area where the catheter is being introduced. That may give you a little bit of a burning sensation. Injection of the contrast material into some of the blood vessels could also either give you a warm sensation or sometimes a burning sensation in that area.

What should I expect during an angiogram?

What you can expect when you have an angiogram is that you'll be brought into a special room called an angiography suite. You'll be placed in the room and placed on a table where you'll be prepared by cleaning off and potentially shaving a portion of your body in order to allow safe entry of the catheter into the body. Once that area is cleaned and you're covered up by sterile drapes used for a surgical procedure, then you will have some local anesthetic placed in the area where the catheter will be inserted. After that, then your radiologist will then place the catheter into the blood vessel and inject iodine dye in the appropriate locations in order to see the blood vessels of interest. At the end of the angiogram procedure, the radiologist will remove the catheter that was initially placed into your artery. A small hole was created when the catheter was initially placed, some bleeding can occur from that hole. As a result, some pressure may be placed on that puncture site in order to allow that area to heal or a closure device is placed into that area in order to stop bleeding. In any event the bleeding usually will be managed in a matter of ten to fifteen minutes and then you'll be sent to a recovery room.

What are the benefits of angiography?

The benefits from angiogram are that it allows us detailed images of blood vessels of the body. It allows us to, in a real time fashion, see what the blood flow is like. We can also more strategically enter into smaller and smaller blood vessels in order to get more information about those small blood vessels. Not only that, if we do find an anomaly of a blood vessel, such as a narrow blood vessel we can perform procedures which open those blood vessels up at the same time.

What are the risks of angiography?

The potential risks of the procedure can include; bleeding, infection or blot clots that can form on the catheter and travel to various parts of the body and close up some blood vessels. This is a very rare event. In some instances, if you have an allergic reaction to the medication, that could require our providing additional medical treatment in order to treat that allergic reaction.

Who is not a good candidate for angiography?

Those patients who have severe allergies to iodinated contrast materials, or who have severe kidney disease may not be very good candidates for angiography. However, even in those patients, angiography can still be performed if appropriate preparations are made.