Arteriogram
Principle
- Arteriography is a procedure in which a contrast material is injected into an artery to evaluate the vasculature.
- An arteriogram can be used to examine almost any artery.
- CT and MRI have replaced the need for angiograms. It is rarely done nowadays for diagnostic purposes.
- However, the therapeutic applications of angiography have expanded considerably.
How it is done
- A catheter is placed into the blood vessel of interest, contrast material is injected and xrays are taken.
- The entry point is either the Femoral or Brachial arteries.
Example Indications
- Cerebral angiography: Aneurysms, Tumors
- Renal angiography: Renovascular hypertension
- Pulmonary angiography: Pulmonary embolism
- Right or left heart ventriculography
- Coronary angiography: Angina or Myocardial infarction
- Aortic angiography: Dissecting aneurysm
- Eye angiography: Diabetic
Advantages
- Arteriograms give the best pictures of the arteries.
- Arteriograms are used to make specific diagnoses and to help determine what is the best treatment in a particular case.
- Often, the treatment itself can be performed using the same type of catheters used in the arteriogram.
Safety
- Invasive procedure
- Bleeding and injury to the artery
- Contrast complications
- Plaques may be dislodged distal to the catheter producing CVA, arterial occlusion, etc.
Cost
CT angiogram: CTA
- After contrast is injected in a peripheral vein, multiple scans of neck
are obtained during the arterial phase (ie delay for contrast to reach
RV-Pulmonary artery-Pulmonary vein-Left ventricle-Aorta-Carotids-Head.
Smaller amount of contrast is used than an arteriogram and can be repeated
if needed. The arteries below the knee or elbow are not well imaged and will
require catheter angiography.
MR angiogram: MRA
- Contrast enhanced MRA is usually done for visualization of arteries of
head, neck, aorta and lower extremities.
- Advantage: MRA contrast is less toxic to the Kidneys than iodinated
contrast used in CTA. It can diagnose stenosis, aneurysm and abnormal
anatomy of vessels etc. It is not useful for coronary artery disease.
- Disadvantage: The cots and the long time for the examination for the
patient to remain still.