Angiography
Contents:
Description:
In 1896 X-ray opened a new type of radiation and received the first intravital roentgenogram. Only in 40 years in clinical practice methods of X-ray inspection of arteries and veins of the person – an angiography were implemented.
Angiography call X-ray inspection of vessels (arteries, veins), by introduction to a blood channel of the contrast agent allowing to define places of obstruction or narrowing of a vessel, or its pathological expansion (aneurysm) and also existence of internal bleeding, signs and extent of tumoral process and many other diseases which cannot be revealed some other way.
"The image of vessels can be received by various methods. We can obtain information on a condition of vessels by means of a usual angiography, a x-ray computer tomography and a magnetic and resonant tomography. In these cases the image which reflects an anatomic structure of vessels will turn out. And here about functioning of vessels, about their functional state still the additional methods based on the ultrasonic principle can give information is a dopplerography, duplex scanning", - the radiologist A. Halikov tells.
Indications to an angiography:
Mainly the method of an angiography is used for detection of various pathologies of blood vessels (veins, arteries, lymphatic ways) that includes vasoconstriction (stenosis) or obstruction of vessels (occlusion).
The angiography is most often applied to reveal atherosclerotic changes in vessels, and also in diagnosis of heart diseases, assessment of function of kidneys and detection of cysts, tumors and aneurisms – pathological vasodilatations, blood clots, arteriovenous shunts in a brain. Besides the method is used at diagnosis of diseases of a retina of an eye. Also, the angiography is often applied before surgical interventions on an open brain and heart as a method of a preoperative research.
Cerebral angiography of the patient with an arteriovenous malformitsa
Contraindications to an angiography:
If the patient has diseases of kidneys, there is a risk of negative influence of X-ray contrast on their function. Also this method is contraindicated to patients with blood coagulation disturbances, in case of existence at them allergic reactions to iodine or to a contrast agent. In it is modern to medicine there are contrast agents which do not contain iodine that reduces the frequency of allergic reactions during a procedure. Also, as the ionizing radiation negatively influences a fruit, the angiography is not recommended to pregnant women.
Carrying out angiography:
Before a research the doctor has to receive the consent of the patient to the procedure. On the eve of the research tranquilizers are appointed in the evening. Have not breakfast in the morning. In the field of a research hair shave. In 30 minutes yes researches premedication is carried out: administration of antihistaminic drugs (prevention of allergic reactions), tranquilizers, analgetics.
The research is conducted by a puncture (puncture) of a vessel or its catheterization (introduction to a vessel of a special catheter through which then a contrast agent will be entered). Most often carry out catheterization of a femoral artery. Under local anesthesia do a section of skin 0,3 - 0,4 cm long. Find an artery and do an artery puncture by a special needle with a wide gleam. Through this needle enter the metal conductor which is advanced to the necessary level. On the conductor enter a contrast catheter into the necessary point. The conductor is deleted. All actions in a vessel are carried out under control of X-ray television. Through a catheter enter radiopaque substance into a vessel. At the same moment begin high-speed x-ray shooting according to the set program. Pictures are shown, looked through, if necessary do additional pictures. Then delete a catheter, for days apply a bandage area of a puncture. To the patient the bed rest is appointed to days. The health of the patient is watched surely by the attending physician, measurement of temperature and survey of the place of an operative measure is taken.
3D - the computer cerebral angiography showing a node of an arteriovenous malformation
Complications after an angiography:
The complications caused by carrying out a research such as bleeding, infection, shock and in rare instances death.
Allergic reaction to contrast agents can vary on severity from reddening to an anaphylaxis. Risk factors of development of allergic reaction of immediate type to intravenously entered contrast agent include earlier allergic reaction to intravenously entered contrast agent, asthma and an allergy to foodstuff taking place.
To patients with a renal failure, a multiple myeloma and a serious illness of heart, such as congestive heart failure and stenosis of the mouth of an aorta, intravenous administration of a contrast agent is contraindicated. Other contraindications include heavy dehydration, diabetes and a sickemia.
As well as in case of a simple X-ray analysis, in an angiography for obtaining the image x-ray emission is used, but radiation doses at an angiography are higher. Before carrying out a research it is necessary to establish pregnancy existence. At an opportunity, procedures with use of X-ray should be postponed for term after pregnancy, or to use the visualization methods which are not based on radiation such as ultrasonography or magnetic and resonant tomography (MRT).
Children are more sensitive to the radiation therefore procedures with use of X-ray among children should be carried out with care.
