In atherosclerosis and other cardiovascular diseases, the pathological process often affects the peripheral vessels, that is, the vessels of the upper and lower extremities.
To diagnose such diseases, to evaluate the functional state of the vessels and their features, a procedure called angiography is used.
The essence of the procedure
Angiography means X-ray examination of veins and arteries organism by introducing a contrast agent into them. It allows you to assess the state of the vessels and their location, speed and blood flow pathways, identify congenital or acquired anomalies, as well as a vascular network of tumors.
Indications and contraindications
Among the indications for angiography of the vessels of the lower limbs are:
- of the disease of the vessels of the lower extremities: aneurysms, deep vein thrombosis, obliterating atherosclerosis;
- diseases of the iliac vessels and aorta;
- pulmonary thrombosis;
- diabetic foot syndrome;
- lesions of the abdominal aorta;
- embolism and arterial thrombosis;
- compression( squeezing) of vessels from the outside;
- ischemic heart disease;
- diseases that affect the arteries of internal organs;
- assessment of the consequences of vascular injuries;
- control of the performed surgical procedure.
Like any surgery, angiography has some contraindications to the use of .These include:
- chronic heart disease in the stage of decompensation, accompanied by heart failure;
- diseases of internal organs in the stage of decompensation;
- chronic or acute renal failure;
- acute myocardial infarction;
- bleeding disorders;
- is an individual intolerance or an allergy to a contrast agent;
- pregnancy, age to two years.
Applied procedures
Depending on the particular group of vessels that are being diagnosed, the angiography is divided into two types of :
- phlebography of the lower extremities( vein examination);
- arteriography is the study of arteries.
In addition, computer or magnetic resonance imaging( ) can be used in contrast contrast studies. Each of these techniques has its own disadvantages and advantages, so the choice should be made by the attending physician based on the characteristics of the patient's body and other factors.
Preparing for
Since radiographic contrast angiography of veins and arteries refers to invasive procedures and involves the puncture of the vessel of the upper or lower limb, it is performed under strict medical supervision. The patient is hospitalized in the hospital for about two days and carries out the following tests:
- definition of the group and Rhesus factor;
- general, biochemical blood test;
- urinalysis;
- blood coagulogram;
- examination for infectious diseases( HIV, hepatitis, RW);
- ;
- electro- or echocardiogram according to indications.
Before the procedure, the patient is recommended to see the therapist, as well as , stopping the use of a number of medications that can dilute blood( Warfarin, Aspirin, etc.).
Several weeks before the procedure, you must give up alcohol, so as not to give too much stress to the kidneys and liver. You can take food no later than 8 hours before your visit to the clinic.
How is the
performed? The procedure is performed using a special fluoroscopic device( angiograph), a CT apparatus or an MRI.
- The patient is taken to the treatment room, the site is treated with an antiseptic, then local anesthesia is performed and the vessel is punctured in the groin, ulnar fossa, in the wrist or shoulder area.
- The doctor then connects the introducer( the device that provides access to the vessel during the procedure), a thin metal probe is inserted into the vein or artery, and the catheter is a hollow plastic tube.
- After confirming that the catheter is correctly installed, the doctor introduces a contrast to the patient, which stains the vessel and facilitates its visualization.
Surgical intervention and manipulation do not cause any discomfort to the patient - the may feel hot in the area of contrast introduction .
After the procedure, all devices are deleted, and is applied to the puncture area with a tight bandage .Contrast is excreted from the body through the kidneys for several hours or days( to accelerate the excretion of the substance, the patient is recommended to use more liquid).
Possible complications and postoperative period
In some cases, after the angiography, the following complications develop:
- is allergic to the drugs used in the procedure;
- pain, bleeding, or infiltration at the puncture site;
- impaired renal function due to contrast;
- heart failure.
As with any other surgical procedure, after this patient should be for some time to be under the supervision of experts .The patient is assigned bed rest, and the medical staff should periodically measure his temperature and inspect the puncture site.
Decoding of the results
The interpretation of the results of angiography makes it possible to reveal the features of the vascular structure, the lesions of individual vessels or their segments, the narrowing of the lumens and the violation of blood flow. Variant rates may look different , depending on which particular area is being researched.
In general, the walls of vessels should have smooth contours, and the lumens gradually decrease and smoothly pass into branches .Any deviation gives the doctor reasons to talk about the presence of the corresponding diseases and pathologies.
Abnormalities and diagnoses
The main types of pathology that angiography identifies include:
- Deep venous thrombosis .It is expressed by the violation of the filling of segments of veins with contrast material in violation of their patency. In some cases, the picture may be incomplete or look like a double channel( the so-called "twin vein").
- Arterial stenosis .With arterial stenosis, narrowing of the lumen of the vessels in one or more places can be observed.
It can be concentric or have the appearance of a plaque, sometimes with ulceration. With stenosis in the last stages, the picture is supplemented by poststenotic enlargement.
- Vessel stratification .For this pathology is characterized by the appearance of a false window through which a contrast agent flows. At the same time, the true lumen of the vessel and the false move are observed, which runs in parallel and is filled with contrast later than the true one. In addition, you can see the narrowing of the true lumen, up to the violation of patency.
- Vascular aneurysm .Aneurysm looks like a defect in the wall of the vessel with its expansion. During the examination, the doctor measures the diameter of the affected vessel, the extent and size of the area to which the pathological process has spread. Aneurysm rupture can be diagnosed by the outflow of contrast medium.
Average cost of
The price of angiography of the vessels of the legs may vary depending on the procedure and the size of the area to be inspected. In Russian clinics the price of the procedure starts from 15 thousand rubles , and in foreign centers( in particular, in Israel) - from 7 thousand dollars.
Angiography of the vessels of the extremities is a modern procedure that allows to identify a number of cardiovascular diseases and to prescribe appropriate therapy. With all the rules and recommendations of specialists, angiography takes place without unpleasant consequences, but in some cases it helps to save the patient's life.
