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A presentation on the history, importance, and how-to of angiography.

Lauren Estes

on 30 April 2013

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Transcript of Angiography

Angiography in Radiology - Angiography is a medical technique in which still images or moving images are taken to visualize the blood filled areas of the body. These areas include various veins or arteries located throughout the body as well as the chambers of the heart.
- The term Angiography is derived from the Greek words for 'vessel' and ' to record'.
- Angiography is a way to produce X-ray pictures of the inside of blood vessels. When blood vessels are blocked, damaged or abnormal in any way, chest pain, heart attack, stroke or other problems may occur. Angiography helps your physician determine the source of the problem and the extent of damage to the blood vessel segments that are being examined. What Is Angiography? - An angiogram is an X-ray test that uses a special dye and camera (fluoroscopy) to take pictures of the blood flow in an artery (such as the aorta) or a vein (such as the vena cava).
- An angiogram can be used to look at the arteries or veins in the head, arms, legs, chest, back, or belly.
- The most common angiograms can look at the arteries near the heart (coronary angiogram), lungs (pulmonary angiogram), brain (cerebral angiogram), head and neck (carotid angiogram), legs or arms (peripheral), and the aorta (aortogram). What is an Angiogram? By: Lauren Estes - A major step in cardiac diagnosis was achieved by Werner Forsmann in 1929, with the first attempt at cardiac catheterization and angiocardiography.
- Cardiac cauterisation is where a tube is inserted directly into the arteries surrounding the heart, and a substance is put into the blood which contrasts with the tissue of the heart. Blood flow in the vessels surrounding the heart can then easily be seen.
- A further turning point came in 1941 when André Frédéric Cournand demonstrated that cardiac catheterization was a safe method in man.
-In 1953, Sven Ivar Seldinger developed his percutaneous technique for cardiac catheterization. Using this technique, the catheter is introduced into the body at a remote site (usually the femoral artery) and the wire is threaded up the arterial system to the heart where the dye is introduced. This procedure is still used today and makes getting an angiogram much safer as no sharp object needs to be introduced near the heart nor does it need to remain inside any vessel. The History of Angiography - In 1927, neurologist Egas Moniz of Portugal developed a technique for a contrasted x-ray of the brain, called a cerebral angiography. He later won the Nobel Prize for medicine in 1949. His technique was used to diagnose several diseases of the nervous system. History of the Cerebral Angiography - An area of the body, usually the groin, is cleaned and numbed with a local numbing anesthetic. A thin, hollow tube called a catheter is placed through an artery and carefully moved up through the main blood vessels in the belly area and chest and into the carotid artery in the neck. X-rays help guide the doctor to the correct position. How to Perform a Cerebral Angiogram - Once the catheter is in place, the doctor releases a special dye (made up of contrast material) into the catheter. Sequential x-ray images are taken within seconds of each other to see how the dye moves through the artery and blood vessels of the brain. The dye helps highlight any blockages in blood flow and allows the doctor identify and diagnose the blockage. How to Perform a Cerebral Angiogram Step #3 and #4 - Releasing the Dye and Imaging Step #1 and #2 - Prep and Insertion of Catheter - After the x-rays are taken, the needle and catheter are withdrawn. Pressure is immediately applied on the leg at the site of insertion for 10 - 15 minutes to stop the bleeding.
- After that time, the area is checked and a tight bandage is applied. The leg should be kept straight for 4 - 6 hours after the procedure and watched the area for bleeding for at least the next 12 hours. How to Perform a Cerebral Angiogram Step #5- Post Procedure Care - New technology has created programs that helps doctors differentiate between the bones and tissues and the blood vessels, so that only the arteries and veins that are filled with the contrast dye are seen. This is called digital subtraction angiography (DSA). Modern Technology If you have the symptoms for:
abnormal blood vessels (vascular malformation) aneurysm (narrowing of the arteries in the brain) vasculitis
It is sometimes used to confirm
brain tumor
evaluate the arteries of the head and neck before surgery,
to find a clot that may have caused a stroke.
- In some cases, this procedure may be used to get more detailed information after something abnormal has been detected by an MRI or CT scan of the head. Reasons for an Angiogram Cerebral hemorrhage

Metastatic brain tumor

Neurosyphilis Abnormal Results Could Indicate: Optic glioma

Pituitary tumor

Primary brain tumors Possible complications include:
- Allergic reaction to the contrast dye
- Blood clot or bleeding at the needle stick site, which could partly block blood flow to the leg
- Damage to an artery or artery wall from the catheter, which can block blood flow and cause a stroke (rare) Possible Risks - CT angiography, or computed tomography angiography, allows physicians to create detailed images of the heart arteries to ascertain if a patient requires traditional invasive diagnostic angiography by using an innovative form of 3D CT scanners.
- This latest advance in noninvasive cardiac imaging allows for visualization of internal structures within the human body by creating a collection of 64 thin-slice images that, when combined, form a three-dimensional view of the patient’s anatomy. The Latest in Angiography Technology - This new technology allows for low-risk patients, with limited symptoms or slightly abnormal stress test results to be tested in a non-invasive method before moving on to a procedure such as an angiogram.
- Before this new technology, 20% of cases that underwent this procedure found negative results, indicating they were healthy and did not require the procedure in the first place. Why Is This New Technology Helpful? What A Cerebral Angiogram
Should Look Like - This technology is extremely important because it helps to identify and diagnose blood clots as they form. They can then use procedures such as angioplasty to prevent tissue infarction (when tissue dies as a result of lack of blood and oxygen to the tissue).
- If the tissue is left without blood and oxygen for too long, the infarction can cause seizures and heart attacks, so by acknowledging the symptoms and signs associated with blocked blood vessels, doctors can use this procedure to locate any serious blockages.
- Though this specific procedure does not fix the blockage, there are similar methods such as angioplasty that can correct the problem after the blockage is located using angiography. WHY IS THIS IMPORTANT!?! - For patients not covered by health insurance, the cost of an angiogram can range from less than $5,000 -$100,000 or more, depending on the facility and the area of the body being examined.
- In general, angiography of the arms, legs, head and chest costs less than angiography of the abdomen or spine.
- According to NewChoiceHealth.com, an arm angiogram costs an average of $4,700, a chest angiogram costs an average of $4,800, a head and neck angiogram costs an average of $16,200, a spinal angiogram costs an average of $17,800, and an abdominal angiogram costs an average of $30,800. Costs:
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