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AngiographyAngiography is a technique based on the x-ray that allows to study the blood vessels and their journey in any area of the body. It consists of introducing a long cable, called catheterthrough the blood vessels. Once inside, instills a radiocontrast into the vessels to study, and vessels 'drawn' in the image can be seen by x-ray. Some of its uses has been displaced by doppler ultrasound, which allows to measure the flow of blood, but still it is essential for the anatomical study of blood vessels, to schedule a surgery, or to intervene directly by catheterization.
This test was invented in 1927 by Portuguese Dr. Egas Moniz. At the beginning very sharp simple catheters were used so that they could move through the bloodstream without forming thrombi. Today, thanks to the Seldinger technique and anticoagulant drugs, can be flexible catheters.
It is not a risk-free test, but complications are rare. Today seeks to use less aggressive techniques for the study of the blood vessels that wherever possible, but angiography becomes forced and especially useful technique when she is suspect diseases that can be treated through radiological intervention, i.e. through catheters which carry out different therapies in the organs through the arteries or veins.
When an angiogram is doneAngiography he is performed when you want to study blood vessels (arteries or veins) for any of these problems:
Partial or complete blood vessel obstruction: any artery or vein may see reduced its light; the most frequent cause is the formation of cholesterol plaques. Some of the consequences associated with this disorder are cardiac, cerebral or intestinal infarction, but any organ can be affected according to the blocked blood vessel.
Stenosis arterial: stenosis is a narrowing of the arteries that depends directly on all the glass, unlike obstructions, which are produced by the formation of obstacles inside. One of the most frequent and important stenosis is stenosis of the renal arteries.
Blood malformation: angiographic study allows us to visualize the ramifications of the arteries, that can sometimes be disorganized and weak. These anomalies can be present at birth or appear throughout life.
Internal bleeding: sometimes it is not easy to identify what is the point whereby a blood loss is occurring. Angiography allows you to see directly where the rupture of artery or vein that escapes the radiocontrast.
Venous varicosity: the venography is a technique that is not often used today, but is still useful to check the venous permeability in all respects and plan the surgery.
Identification of tumors: angiography can help locate malignant tumors, since the circulation in them is very irregular and can be seen with this test.
Surgery planning: in some special situations it is necessary to perform an angiogram to study the anatomy of the blood circulation in the area that will be performed, although today used very little, thanks to the development of the computerized axial tomography (CAT).
Buerger's disease: in this pathology the arteries in the arms and legs suffer reactions fibrotic who cut them and deform them, thus preventing blood flow. Its main cause is tobacco, and angiography visualizes the characteristic shapes of the arteries in the form of corkscrew.
Preparation for angiographyIf they are going to carry out an angiography , these are issues that you must take into account:
Duration: the duration of angiography is variable. It can last from a few minutes to more than one hour. It tends to take more time when it decides to intervene on the vessels studied at the same time.
Income: it may be necessary to enter the night before the test, and after it is usual that you stay a few hours in observation, and sometimes it is necessary to enter a night in the hospital.
Is necessary to be accompanied?: Yes, it is recommended to carry a passenger. It is a test not exempt of risks and is better after you undergo the same there is someone to take home and remain at your side a few hours.
Drugs: you must tell your doctor all the medicines you take regularly, and will decide which suspend or maintain. Sometimes the doctor will recommend you take medication that will help to carry out the test, but should be assessed for each patient on an individual basis.
Food: must remain in fasting 8 hours before you undergo an angiogram.
Clothes: you can go with the same clothes every day, and when you get to the medical center you will be asked you to take it off and will put a robe of income, which is more comfortable and hygienic for the test.
Documents: it is recommended to carry the personal medical history, although the doctor will already have it with him. Before put you to the test you will sign the informed consent with which you agree to make yourself the technique and you will know the potential risks, which are rare. They will also make you a series of basic, such as an electrocardiogram or a blood analysis tests; take the results with you if you have taken them.
Pregnancy and breast-feeding: angiography is contraindicated in these situations. If there is a minimal chance of being pregnant not you should submit to this test, since exposure to X rays and the radiocontrast may harm the fetus. Usually the doctor performed a pregnancy test prior to women who do not deny being pregnant.
Breastfeeding does not imply a direct contraindication, but it is better to avoid testing until the breast feeding period is complete unless it is strictly necessary.
Contraindications: pregnancy would be a contra-indication for angiography. You do if you have a chronic kidney damage since the radiocontrast can disable them. People who have an active infection nor should undergo this test if it is not strictly necessary.
How angiographyWhen you go to perform angiography, firstly they will ask you if you're in agreement with put yourself to the test and you will be asked to sign the informed consent, where you will read what is. You cite that you submit to the test another day and explain how you have to go to it.
To make you the proof may be required that you enter the night before or not. If you go directly in the morning you should not forget to remain in fasting 8 hours before. Go to the quiet and accompanied, hospital with enough time to not stress yourself before the test. Before entering the room where the test you will be ask you that you change your clothes and give you a batin's hospital. Once inside, you will see multiple monitors and a table where you tumbarás you face up.
Before starting the intervention you will you a sleeve on the arm to control blood pressure, several electrodes on the chest to control the heart rate, and a vein in the other arm via in case you need to inject some drug. Depending on the area to study they will introduce you the catheter on the one hand body or another. Normally they take advantage of large blood vessels to make it easier to puncture them, such as the iliac artery in the groin or the subclavian vein in the shoulder. The area that is puncture is shaved and should be cleaned with antiseptic to maintain correct measures of asepsis.
In the shave zone a little local anaesthesia prick before puncturing the main artery. Puncionada once, check that it has reached correctly and be introduced a thin hollow tube through the needle. After the needle is removed leaving the tube inside the artery, and through this tube is inserted the catheter, which is like a wire. Catheter brought to the region of the body that you want to study; There are different models with different curves to make it easy to iterate through the arteries or veins. All time low radiation x-rays are made to control the passage of the catheter.
When the catheter reaches the area of the body to study will instil radiological contrast. At that time, it is normal that notes heat and hot flashes. Once studied the vessels in the area will decide whether to intervene at the time or not, and when finished will withdraw the catheter. The area where the catheter went be pressed for several minutes to facilitate coagulation, will then be cleaned and will be covered with a bandage.
Finally, you will be into another room to rest and keep you under surveillance a time. Then you will be taken to a hospital room, or you can go to your House taking care with the puncture wound.
Complications of angiographyComplications in angiography are not very frequent. Some that occur occasionally are:
- Discomfort, nausea and vomiting.
- Fainting and loss of consciousness.
- Cardiac arrhythmias.
- Alterations of blood pressure suddenly.
- Allergic reaction to the x-ray contrast medium.
- Cardiac or cerebral infarction.
- Internal bleeding or pericardial.
- Local clots and embolisms.
Results of angiographyThe results of the angiography can be known anything over finished the test. When the blood vessels are intact are observed well shaped, without indentations and loss of contrast.
However, small changes in the test may be misinterpreted, and that it is better that the radiologist or physician who has done it carefully study them and assess them in relation to the rest of the evidence that you made.
More typically, a few days after angiography to cite you for a consultation with the doctor. There he will discuss to what have been the results of the test and will inform you a diagnosis and treatment, if the test has been altered and is final.