Angiography of the vessels what it is, how it is carried out, types, indications and

Before conducting angiography of blood vessels, it is necessary to carry out a number of preparatory steps:

  • The patient is subject to hospitalization, because if there is a suspicion of the presence of a blood vessel disease, then there is a high risk of developing various complications.
  • A full examination by a doctor, an assessment of the general condition of a person.
  • Conducting a series of laboratory tests that make sure the need for angiography, as well as confirm the absence of contraindications.
  • Be sure the patient signs an agreement to conduct a diagnostic procedure.
  • Performing a test test, which will make sure that there is no allergic reaction to the drugs that are used during the study.
  • In some cases, the doctor prescribes sedatives, painkillers and antihistamines several days before the procedure.

To obtain accurate information, you must refuse to take alcohol, drugs and potent drugs 14-25 days before the study. This will reduce the load on the liver and kidneys. If it is impossible to cancel the medication, you must inform your doctor about this.

A few hours before the procedure, you must completely refuse food. In the place of the future puncture (this is reported by the doctor at the preliminary examination), it is necessary to remove (shave) the hair cover and conduct thorough hygiene of this area.

For faster elimination of iodine from the body, it is necessary to drink a sufficiently large amount of liquid (pure water) before and after the procedure. Immediately before angiography of the vessels, all metal jewelry should be removed, as they can distort the results of the study.

At a preliminary conversation with the doctor, it is necessary to report on existing chronic diseases and list all the drugs taken. Some may need to be undone.

If allergic reactions to iodine preparations, painkillers, tranquilizers or other drugs have been noted, this must also be indicated.

It is important to inform your doctor of an existing or suspected pregnancy. X-ray radiation is dangerous for the fetus, so it is better to undergo MRI angiography.

Stages of preparation for angiography

  • Exclude alcohol two weeks before the study.
  • A week before the study, temporarily stop taking blood thinners – Aspirin, Warfarin
  • For 3-5 days, pass the necessary tests and undergo research:
  • For 1-2 days, a test is carried out on the tolerance of a contrast medium. Water-soluble iodide compounds are most commonly used. Intravenously administered 0,1 ml of a solution of the drug for contrast. If there are signs of an allergy: conjunctivitis, rhinitis, urticaria, heart dysfunction, then the procedure is not carried out.
  • On the eve of the study, cleanse the intestines with an enema or glycerin suppositories, since during the procedure and after it will have to maintain a lying position for a long time.
  • In the evening before the procedure, take a shower and remove hair in the area where the puncture will be performed.
  • At night, take tranquilizers, which the doctor will recommend. They help calm down and sleep before the study. Your doctor may also recommend antihistamines to prevent allergies.
  • On the day of the study, do not eat or drink, because with the introduction of a contrast agent, nausea and the urge to vomit are possible.
  • Immediately before the procedure, it is necessary to empty the bladder.
  • With hypertension, it is necessary to normalize the pressure as much as possible. To do this, use the drugs that are most effective for this patient: Dibazol, Hemiton, Raunatin.
  • In case of heart rhythm disturbance, potassium preparations are used: Panangin or potassium chloride. Cardiac glycosides are also effective – Strofantin, Obzidan.
  • With coronary disease and pain in the heart, nitrates are prescribed: Sustak, Erinit, Nitroglycerin under the tongue.
  • With kidney pathology, it is necessary to hydrate the body – saturate it with water. In this case, the contrast agent will have an irritating effect on the kidneys and will be more quickly excreted from the body.
  • In chronic inflammatory processes (bronchitis, tonsillitis, sinusitis), broad-spectrum antibiotics and sulfonamide drugs are prescribed. The course of treatment is 10-14 days.

Angiography of the vessels of the heart is a modern method for diagnosing the blood flow of the heart muscle, examination of arteries, blood vessels. With its help, violations in the work of the heart, the development of pathologies and serious diseases at an early stage are detected. Another name is coronary angiography. To conduct the study, the vessels are filled with contrast fluid, and then with the help of an X-ray, the integrity of the arteries and the movement of blood flow are observed.

Vessels – a thin tissue of the body, which is not determined by standard x-ray diagnostics. Therefore, a contrast is used to track the condition of arteries, veins, and blood vessels. To inject a specific fluid in the vessel, a puncture is made. Thanks to modern medical technology, the blood system of the human body can be viewed in 3D. Such a picture makes available not only the identification of pathologies, but also provides information on the structure of the vessel, wall thickness, and diameter.

Before angiography, the patient receives a number of recommendations on preliminary preparation. Before the procedure, you must take the following actions:

  • Make a general and clinical blood test, a test for HIV and hepatitis, undergo an MRI. These actions will determine the presence of contraindications, to avoid the risk of complications.
  • Do not drink fluids before the procedure. At the time of the examination, the bladder should be empty to obtain accurate indicators.
  • It is necessary to remove metal objects that are close to the body: bracelets, chains, belts, rings and other jewelry. Metal can affect the accuracy of indicators and the results obtained.
  • The doctor conducting the operation should be aware of the patient’s chronic diseases, the drugs used, as well as the intolerance of the drugs. If you are allergic to medical substances, you must tell the diagnostician about this.
  • The questions asked by the doctor must be answered exhaustively and truthfully. Incomplete health information can cause complications.
  • Exclude the use of alcoholic beverages. Ethanol quickly penetrates the blood, changing its composition. This leads to inaccurate results of the analysis and to side effects. Therefore, five days before the procedure, alcohol should be abandoned.
  • Stop smoking. Nicotine smoke has a devastating effect on the body, on the work of the heart muscle and healthy blood circulation. Therefore, tobacco should not be smoked on the day of the examination.

Compliance with the above recommendations will help prepare for the upcoming procedure, reduce the risk of complications.

Coronary angiography of the vessels of the heart is prescribed for suspected cardiovascular pathology. The patient is prescribed for this examination in the presence of the following symptoms:

  • Tachycardia, angina pectoris and other heart diseases.
  • Suspected coronary artery dysfunction.
  • Shortness of breath, headaches and heartaches not associated with another disease.
  • With therapeutic treatment of the heart muscle, the pain syndrome rises.
  • Symptoms of congenital heart disease.
  • Heart palpitations, arrhythmia. The appearance of a cough that is not associated with bronchial disease.
  • Feeling of heart failure.
  • When diagnosing ischemic disease.
  • The results of the analyzes and related examinations are controversial.
  • Stably low blood pressure.
  • Symptoms of thrombophlebitis in the cardiac arteries.
  • Pain in the chest, not passing after a course of drug treatment.
  • Predisposition to myocardial infarction.
  • With the upcoming surgery in the heart muscle.
  • Cardiomyopathy
  • Recent chest injury with complications.
  • Disturbed work of the aorta and coronary arteries.
  • Angina pectoris.
  • Infectious endocarditis.
  • Cardiac arrest with unclear pathogenesis.
  • The upcoming operation of transplantation of internal organs.

The above points are an indication for coronary angiography of the blood vessels of the heart.

Coronography is an effective method for the diagnosis of heart muscle, illustrating the condition of arteries and blood vessels. With its help, pathologies, as well as chronic diseases, can be identified. This study is popular in cardiology and in demand. But, as in all methods of treatment, it has its advantages and disadvantages.

The survey method is not difficult, and affordable price increases demand. Coronography of the blood vessels of the heart does not have serious drawbacks. The patient feels pain with the introduction of a contrast agent and catheter.

If the preparation for the procedure is followed, all points are made, no complications occur. But in some cases, the following are possible:

  • Cardiopalmus.
  • An allergic reaction to an iodine-specific fluid that is injected into the heart vessel.
  • Bleeding during bending or tension to the area in which the artery was punctured.
  • Myocardial infarction.
  • Infection when working with non-sterile instruments.
  • Renal failure.

Before carrying out the procedure, it is important to check for an allergic reaction to a specific contrast medium. If an allergy is diagnosed, it is better to refuse coronography of the blood vessels of the heart, preferring a different diagnostic method. It is also necessary to examine the condition and health of the kidneys to rule out complications.

Before conducting a diagnosis using angiography, the patient is assigned several tests to exclude possible contraindications:

  • general blood and urine analysis;
  • blood chemistry;
  • blood coagulation test (coagulogram);
  • blood sugar test, markers of viral hepatitis, Wasserman reaction;
  • blood test for Rh factor and group (if not known).

A week before the procedure, you need to stop taking any alcohol. If you are taking drugs that thin the blood, affect its coagulability, be sure to inform your doctor.

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Types of angiography and their purpose, which diseases can be diagnosed

Angiography is divided into two types:

  • puncture – used to study surface vessels;
  • catheterization – used with a deep arrangement of veins and arteries that need to be examined.

When puncture, the contrast agent is injected directly using a special syringe. With catheterization, the procedure is somewhat more complicated. The drug is administered through the tubes of special devices (introducer, catheter). In this case, a special incision is made in the skin and subcutaneous tissues using anesthesia.

Standard angiography diagnostics are performed on a digital fluoroscope. There are also CT and MRI angiography.

The study of arteries is called arteriography, veins – phlebography.

Specialists distinguish types of angiography by the localization of the examined vessels:

  • cerebral angiography – a study of cerebral arteries;
  • portography – a study of the veins of the liver;
  • coronarography – cardiac arteries;
  • angiopulmonography – examines the vessels of the lungs;
  • aortoarteriography – examines the aorta and all arteries of the internal organs extending from it;
  • angiography of arteries and veins of the lower extremities.

The essence of the survey

For angiography, id-containing contrast agents are used. They are ionic and nonionic. By the criterion of minimizing side effects, preference is given to non-ionic contrast agents.

After administration, the substance spreads through the vessels along with the bloodstream. First, it enters the arteries, then into the smaller vessels of the arterioles and capillaries, then into the smaller and larger veins.

The faster the blood flow, the faster the movement of the contrast medium. As it spreads, the apparatus on which the study is being conducted takes several x-rays.

Two methods of angiography are used: invasive, non-invasive and selective. In the first case, an iodine-based contrast agent is introduced. The second method involves ultrasound and computed tomography examination. With a selective diagnostic method, only certain parts of the heart muscle are studied.

General angiography

This examination method is considered standard. With its help, all vessels of the heart muscle are examined, contrast fluid on the iodine basis is injected into all arteries and vessels. Information about the state of blood circulation, about how healthy the vascular blood flow is, is recorded on a disc or displayed on a picture.

The differences of this examination method are that the emphasis is on a specific area or vessel of the heart muscle. The use of a catheter is used, with which a specific contrast agent penetrates into the desired artery. The results of the study are displayed on a film in three-dimensional format. The peculiarity of this procedure is the minimum amount of contrast fluid and the short time of the procedure. Due to this, the examination can be repeated using other angles.

Multispiral computed tomographic diagnostics – MSCT. It is characterized by increased effectiveness, because it allows you to examine all arteries, vessels and valves of the heart muscle. Arteries are filled with specific fluid, then the patient is placed on a couch under the tomograph. Survey results are obtained in 3D format.

The difference from standard type angiography is in the following advantages:

  • The procedure does not take a long time; hospitalization of the patient is not required.
  • There is no risk of side effects or complications. The procedure is completely safe and harmless to the body and is applicable even to children.
  • It allows you to examine shunts and stents, determines the type of atherosclerotic plaques, carotid atherosclerosis.
  • Thanks to the high-quality image in three-dimensional format, it is possible to examine the heart muscle from different sides.

The computerized method of examination is a modern, effective method for identifying pathologies and disorders of the heart muscle. The absence of pathologies and complications during the diagnosis makes it popular, known. The doctor prescribes computer diagnostics for elderly, infirm patients. Subsequent hospitalization is not required.

The examination method is notable for its safety, the absence of complications. Special long-term preparation is not required. The procedure is carried out by introducing a contrast medium into the ulnar blood vessel and the subsequent image on the tomographic apparatus. The examination process takes no longer than five minutes, does not require anesthesia, as well as hospitalization. After the analysis, the patient can return to his usual life.

A study of stent patency during shunting is possible without the risk of myocardial infarction. This diagnostic method is not able to replace standard angiography, because it does not reveal a holistic picture of the state of blood vessels and blood circulation of the brain. Disorders of individual arteries are highlighted. The procedure is carried out in an inpatient setting by a laboratory doctor. The results of the examination are transmitted to the attending physician.

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Organs and tissues absorb ionizing radiation. High organ density is reflected in a lighter area in the image. The network of cerebral vessels does not accumulate photons, since the liquid in them is in continuous motion. Therefore, the visualization in the image is rather weak and not informative with a standard study.

Brain angiography refers to a method of contrast diagnosis using non-invasive radiography. An iodine-based contrast medium is injected into the bloodstream. Blood flow carries the drug throughout all vessels, including the capillary network.

Iodine actively absorbs X-rays, which helps to examine the vasculature in the brain and detect pathological changes. As shown by angiography, a series of images makes it possible to evaluate blood circulation in the brain and discover the cause of impaired patency in the vascular network.

The need for angiography will be determined by a medical consultation or one of the narrow specialists (surgeon, neurologist, oncologist). Indications are subjective complaints of the patient or an established diagnosis.

Objective reasons for the diagnosis:

  • Migraine;
  • Fainting;
  • Epipristes;
  • Vomiting that does not relieve headaches;
  • Lack of coordination (staggering gait);
  • Cerebral stenosis;
  • Atherosclerosis;
  • Suspicion of the presence of a tumor or diagnostic control after surgery;
  • A history of vascular pathology;
  • Suspicion of acute cerebrovascular accident;
  • The dynamics of the therapy.

It is possible to make angiography of cerebral vessels a classic method only after passing a medical examination. If there are contraindications, the procedure is not prescribed. One of the fluoroscopic diagnostic methods is selected – computer angiography or MRA.

Advantages

Angiography of the brain allows you to accurately determine the cause of pathological changes in blood vessels or to identify congenital malformations. A contrast drug penetrates even the smallest intracranial vessels and does not require exposure to high doses of radiation.

Visualization of the brain vessels in the image is possible in several projections, which allows us to consider the dynamics of blood flow and its phase. This method has no age restrictions, complications after the procedure are rare.

Angiography refers to a high-precision diagnostic method that allows you to track the extent of the pathological process, as well as identify rare chronic diseases.

The procedure takes a short period of time and in comparison with other methods the most budgetary.

Brain angiography is prescribed only by a doctor after a thorough examination and preparation of the patient. An angiogram of the brain using a contrast agent is carried out after a preliminary test for an allergic reaction.

The choice of methodology depends on the indications and contraindications:

  1. Standard method;
  2. MRI diagnostics;
  3. CT diagnostics.

Before the procedure, the patient is warned of possible complications. To monitor the condition, the patient may be offered medical supervision on the day of the study, for which hospitalization for 1 to 3 days is required. After the study, a feeling of general weakness and chills is possible.

CT angiography

CT angiography of the vessels of the brain and neck is performed using a radiopaque substance. The method is similar to the classic, but is considered more informative. Visualization of cerebral vessels occurs using a tomograph, which allows you to view the image on a computer screen or simulate a three-dimensional image on a film.

CT of cerebral vessels has a lower radiation burden on the body, in contrast to the x-ray apparatus. The study has minimal risks of developing serious complications.

A subspecies of computed tomography is multispiral (MSCT). The general diagnostic principles for the methods are absolutely identical. The difference is in the equipment.

More often, for the diagnosis of cerebral vessels, MSCT is chosen. Angiography by this method takes only a few minutes, in contrast to CT, which allows the study of seriously ill patients who cannot maintain a fixed body position for a long period of time.

Sensors in a multispiral tomograph are located around the entire circumference of the apparatus. When scanning, the device slowly turns, making a smooth spiral motion – from here the procedure got its name.

To scan the vascular network of the brain, only one revolution is needed. In a few minutes, the doctor receives a clear, informative picture. Computed tomography is inferior to MSCT in terms of informativeness, but is considered to be whiter than affordable (budget).

Advantages of multislice CT:

  1. A wider list of settings in the device, which allows you to change the settings for each patient;
  2. Lower ionizing radiation (30% difference);
  3. Simultaneous examination of soft tissues and bone fragments;
  4. The minimum research time allows the procedure to be performed for children and seriously ill patients (including those connected to life support equipment);
  5. Detects neoplasms from the moment of nucleation (up to 1 mm);
  6. Visualizes hematomas in the brain.

MSCT is possible for patients with somatic diseases (mental) or people suffering from claustrophobia. The speed of the procedure does not provoke panic attacks when placing the patient in the tomograph.

Multispiral computed tomography allows you to get a greater number of images in a short period of time. This is achieved by thinner sections, in contrast to CT.

The average duration of a CT scan is at least 15 minutes, subject to the instructions of the diagnostician during the study (hold your breath, do not move). The study is stopped after reconstruction of the obtained information into a clear three-dimensional image.

MR angiography

MR angiography of cerebral vessels is considered a more modern diagnostic method. Visualization of the circulatory network in the image is obtained by the action of electromagnetic fields.

What is this and what is the essence of the methodology – a strong magnetic field is created in the tomograph, since the positions of the hydrogen nuclei change. The magnetic field and radio frequency radiation acts with a certain force, which leads to the rotation of the core around the created axes.

Indications for examination

The list of diseases in which angiographic diagnosis can be prescribed is quite extensive.

The method helps to study the patient’s condition with a number of brain pathologies:

  • hemorrhagic stroke;
  • heart attack;
  • craniocerebral trauma;
  • malignant neoplasms;
  • aneurysm (vasodilation);
  • angioma;
  • vascular malformation.

When examining the heart, angiography is indicated in cases:

  • ischemic heart disease;
  • heart attack;
  • congenital diseases of the coronary vessels;
  • atherosclerosis of the coronary arteries.

Diagnosis using angiography is recommended for diseases of the vessels of the arms and legs:

  • atherosclerosis;
  • thrombosis;
  • diabetic foot syndrome in diabetes;
  • stratified aneurysm of the arteries of the hands or feet.

In addition, angiography is prescribed after injuries in cases of suspected damage to blood vessels.

If angiography can worsen the condition of the patient, it is recommended to replace it with MRI or ultrasound.

Contraindications for angiography:

  • iodine allergy;
  • pregnancy at any time;
  • heart, liver, or kidney failure;
  • acute infectious or viral diseases;
  • bleeding disorders;
  • thrombophlebitis (thrombus detachment and blockage of the vessel may occur);
  • mental disorders (the patient will not be able to follow the doctor’s commands).

Angiography is performed in a hospital equipped with the necessary equipment. It can be a modern diagnostic center, hospital, clinic.

The patient lies on the table of a special apparatus (angiograph). The puncture site of the vessel is treated with antiseptics. The location of the injection site depends on the purpose of the study. For angiography of the vessels of the brain, head, hands, the inner surface of the forearm or shoulder is selected. Three arteries are located here: radial, ulnar and brachial.

Then the skin and vessel are pierced with special needles. Introducer (tube probe) is inserted into the lumen of the artery, into which other instruments are then inserted if necessary. Including a thin (about 2 mm in diameter) catheter, to which a syringe is connected to inject a contrast iodine-containing substance.

When the drug passes through this area, X-rays are passed, which make it possible to display the vessel and the site of introduction of the catheter on the monitor. Under such an X-ray video control, the catheter is brought to the vessel, a snapshot of which is the purpose of the study. A contrast agent is injected into this place, photos are taken using X-rays.

After angiography, it is recommended that doctors be monitored for 12-24 hours to exclude possible complications.

  • An tranquilizer and antihistamine are administered intramuscularly before the procedure. This helps reduce anxiety and prevent the development of an allergic reaction to the contrast medium.
  • An antiseptic is treated with the desired area of ​​the skin.
  • Anesthetic lidocaine is administered subcutaneously. He anesthetizes the area where they will make a puncture.
  • A small incision is made on the skin to gain access to the artery.
  • Install the introducer – a short hollow tube.
  • Novocaine solution is injected into the test vessel to prevent vasospasm and reduce the irritating effect of the contrast agent.
  • A catheter (thin flexible tube with a diameter of 1,5-2 mm) is inserted inside the introducer. It is advanced to the mouth of the test vessel under x-ray control.
  • Contrast medium is introduced (Gipak, Urografin, Cardiotrust, Triotrust) and shooting is carried out. If necessary, this step is repeated 2-3 times.
  • Remove the catheter and stop the bleeding.
  • A sterile pressure dressing is applied.
  • They recommend bed rest for 6-10 hours to prevent the formation of a blood clot.

The site of insertion of the catheter is chosen as close as possible to the area that needs to be examined. This allows to minimize vascular trauma and the amount of contrast medium.

The procedure is performed by a team of highly qualified doctors: radiologist, anesthesiologist and cardioreanatologist.

– A method of studying the vessels of the head to identify brain pathologies.

Where is the contrast agent injected? Catheterize the brachial, ulnar, subclavian, or right femoral arteries. The catheter is advanced to the point of branching of the desired vessel in the brain and a contrast medium is introduced into its lumen.

When is an x-ray taken? After the introduction of the first portion of contrast, the head is taken in different projections (front and side). Pictures are immediately evaluated. In order to study the departments of the vessel that are distant from the center, they introduce a new portion of contrast and repeat the survey. After the substance passes through the tissues, it appears in the veins. During this period, they make the next series of shots. At this point, the catheter or puncture needle is removed and the examination is considered complete.

What sensations can occur during the procedure? During catheterization, the patient is given local anesthesia to anesthetize the site of catheter insertion. With the advancement of the catheter through the vessels there will be no pain, since their inner wall is deprived of pain receptors. With the introduction of a contrast agent, a metallic taste may appear in the mouth, a feeling of warmth, redness of the face. These phenomena pass independently in a few minutes.

– study of the coronary vessels of the heart.

Where is the contrast agent injected? To study the coronary arteries of the heart, it is necessary to insert a catheter into the femoral artery in the area of ​​the inguinal fold or into the radial artery on the wrist. Under the control of X-ray television, the catheter is advanced to the aorta, from which the coronary arteries depart. When the tube reaches the desired vessels, a portion of the radiopaque substance is fed through the channel. It is injected alternately into the left and right coronary arteries.

When is an x-ray taken? A contrast agent fills the lumen of the blood vessels of the heart in a few seconds. During this period, they make a series of shots from different projections.

What sensations can occur during the procedure? When the contrast medium fills the blood vessels, a temporary sensation of heat appears, especially in the face. If the catheter touches the wall of the heart, heart rhythm disturbances occur. Due to lower blood pressure, the patient may feel dizzy. Occasionally cough and nausea appear. Report your feelings; the medical staff knows how to help deal with these side effects.

– study of arteries and veins of the upper and lower extremities.

Where is the contrast agent injected? When examining the upper extremities, 10-15 ml of contrast medium is injected into the brachial artery.

When examining the vessels of the lower extremities, a catheter is inserted into the femoral artery or abdominal aorta. If it is necessary to contrast the vessels of the lower leg and foot, a puncture is made in the posterior tibial artery.

How is x-ray taken? After the contrast has filled the vessels, serial shooting is carried out using two perpendicular x-ray tubes. They simultaneously turn on at certain intervals.

What sensations can occur during the procedure? Due to local anesthesia, there is no pain when a catheter is inserted. At the moment the contrast is introduced, a feeling of heat and a metallic taste in the mouth appear.

PathologyDestination purposeSigns of this disease
AneurysmIdentify vascular pathology that can lead to a strokeSack-like protrusion into the walls of the artery of the brain
AngiomaDetect vascular tumorPlexus of dilated blood vessels or spongy cavities filled with contrast medium
Ischemic stroke (heart attack) of the brainDetermine the need for thrombolysis (thrombus dissolution)More than 95% blockage of the artery
Hemorrhagic strokeIdentify the source of cerebral hemorrhageRupture of the vessel from which the contrast agent flows
Vascular malformationDetermine the location of the pathology, the source of bleedingThe contrast agent flows directly from the artery to the artery or vein, bypassing the capillaries
The output of contrast medium through the vessel wall
Accumulation of abnormal sinuous vessels at the site of malformation
Head injuryIdentify the consequences of head injuryDilation of superficial veins of the brain
Slow down blood flow
Long stagnation of contrast medium in vessels
HematomaDetermine the location and size of the hematomaA section of brain tissue is slowly saturated with contrast medium.
Border of different widths from the cranial vault to its base. In the affected hemisphere
EncephalomaDetermine the nature and size of the tumorMalignant tumors have a branched vascular network and good blood flow.
Benign tumors contain less newly formed vessels
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PathologyDestination purposeSigns of this disease
Atherosclerotic disease of the arteries of the lower extremitiesDetermine the degree of vasoconstrictionLocal narrowing of arteries with a length of several mm
The inner contours of the vessels are not even
With a far-reaching process, the lumen of the artery is completely blocked, and the contrast medium passes bypasses through the small arteries
Obliterating endarteritis or diabetic foot syndromeDetermine the degree of damage to the vessels of the lower extremitiesDeformation of the wall of the vessels of the foot
Parietal thrombi, narrowing the lumen of the arteries
Slowing blood flow in the lower leg and foot
Contrast material is poorly visible in distant (distal) parts of the vessels
Arterial thrombosis or thromboembolism, thrombophlebitisIdentify the location of the thrombus, its size, the degree of narrowing of the arteriesVascular lumen narrowing or complete blockage
The emergence of workarounds
Vascular injuryDetermine the presence of deformation of the vesselSqueezing the vessel, reducing its clearance
The release of contrast medium into the surrounding tissue upon rupture of the vessel
Stratified arterial aneurysm;Determine the location of the defect in the artery wall, the length of the stratificationStratification of the artery wall with the formation of a false channel, where the contrast agent enters
The contours of the arteries are deformed
Monitoring the effectiveness of surgical and drug treatmentTo evaluate the results of treatment: whether the blood clot or atherosclerotic deposits decreased, if the lumen of the vessel returned to normalNarrowing clearance
Vessel blockage
PathologyDestination purposeSigns of this disease
Coronary heart diseaseDetermine the degree of damage to the blood vessels of the heartLocal or extended narrowing of the lumen of the vessel
Vessel blockage (occlusion)
MyocardialIdentify the site of circulatory disorders, the degree of blockage of arteriesBlockage of the vessel, a sharp break in its shadow
Lack of pulsation of the heart wall in the affected area
Atherosclerosis of the coronary arteriesDetermine the extent and extent of the processDeposition of atherosclerotic plaques at the branch of arteries – wellhead sclerosis
Vessel narrowing in a limited or extended area
Jagged vessel
Congenital coronary artery diseaseDetermine the type of pathology and the need for surgical treatmentProtrusion of the artery wall
Abnormal location of the right or left coronary artery
The site of narrowing, expansion, tortuosity of the artery
SymptomAs manifestedWhat pathology indicates
Pathological atrio-venous messagesTransition of contrast medium from arteries to veins, bypassing capillariesCongenital vascular pathology
Lack of visualization of individual arteries or their partsThe image of the vessel is abruptly interruptedAtherosclerosis
Arterial Thrombosis
Narrowing of the venous sinusesNarrowing the lumen of the venous sinuses – spaces located between the sheets of the dura materThe consequences of traumatic brain injury
Venous Sinus Thrombosis
Decreased blood flow in selected areas
Vasoconstriction
Contrast is slower in narrowed arteries than in otherAtherosclerotic cerebrovascular disease
Vascular compression by edematous brain tissue after inflammatory processes and traumatic brain injuries
Cerebral ischemia
Brain hemorrhageA bursting vessel is detected by the release of contrast medium into the surrounding tissue.Cerebral artery aneurysm
Hemorrhagic stroke
Traumatic brain injury
Hematoma
Rough contours of the great arteriesRough contours of vessels as a result of parietal deposits
Bulging vascular wall
Aneurysm
Atherosclerosis
The formation of parietal thrombi
Congenital vascular pathology of the brain
SymptomAs manifestedWhat pathology indicates
Occlusion (blockage of veins and arteries)Due to blockage of the vessel, the contrast medium does not spread along its channelThrombosis
Thrombophlebitis
Thromboembolism
StenosisThe narrowing of the lumen of the vessel by 30-90%Atherosclerosis
Acute and chronic ischemic disease
Squeezing a vessel with a tumor or hematoma
Thrombosis, thrombophlebitis
Arteritis, phlebitis
Endarteritis
Congenital vascular pathology
VasodilatationVascular Dilation
Tortuosity of blood vessels
Bulging vascular wall
Varicose disease
Congenital pathologies
Aneurysms
Vascular malformationsThe site of abnormal branching or tortuosity of the vessel
Overflow of contrast medium into another artery, vein or lymph vessel
Contrast-filled cavities
Congenital malformations of blood vessels
SymptomAs manifestedWhat pathology indicates
Coronary artery occlusionBlockage of the vessel, narrowing of its lumen by more than 90%Coronary thrombosis
Embolism
Atherosclerosis
StenosisThe narrowing of the lumen of the vessel by 30-90%Atherosclerosis
Coronary heart disease
Hematoma due to chest injury or heart surgery
Arteritis
Myocarditis
Congenital malformations of the coronary vessels
Mouth stenosisNarrowing within 3 mm from the beginning of the vesselCoronary atherosclerosis
Arteritis
Thrombosis
Anomalies in the development of coronary vesselsTwist, narrowing, expansion of arteries and veins
Transition of contrast medium from one vessel to another
Abnormal location of coronary vessels
Vascular malformations
Heart defects
Coronary Artery Aneurysm
Coronary artery calcificationNarrowing the lumen of blood vessels as a result of calcium deposition on the wallsEndocarditis
The consequences of atherosclerosis
AneurysmProtrusion of the artery wallAtherosclerosis
Fibromuscular dysplasia
Endocarditis
The consequences of a chest injury

Contraindications to angiography of blood vessels

Decoding of the results of angiography is carried out on the basis of a study of blood vessels and a number of pathologies associated with the functioning of the patient’s cardiovascular system may be detected:

  • the presence of increased bleaching, luminescence indicates a violation of the patency of the vein or epiretinal membrane. There is a chance of developing angiogenesis;
  • areas with low light may indicate aneurysms;
  • the exit of the dye or contrast medium beyond the walls of the vessels indicates their damage;
  • a change in blood flow velocity (slowness or complete absence) indicates a blockage of blood vessels.

The presence of a variety of complications or any initial stages of the disease can only be seen by an experienced doctor, therefore, decipher the results of angiography and diagnosis should not be carried out independently.

Interpretation of images after cerebral angiography is carried out only by a diagnostician. The diagnosis requires special knowledge from a doctor.

The density of the tissue on the film is reflected in a different color, this is affected by the degree of absorption of x-rays:

  • Bone tissue (the densest) – in the picture is white;
  • The brain substance is gray;
  • Liquor and vessels filled with contrast are reflected in black.

All brain tissues, their location and shape are evaluated. Particular attention is paid to the vasculature. Normally, the vessels are smooth with smooth bends. The nature of the branching and narrowing of the lumen is evaluated. With a fuzzy image or with the aim of clarifying the diagnosis, a second procedure can be prescribed.

A higher diagnostic information content for the diagnostician is a snapshot obtained after MR angiogram. Vessels can be viewed in a layered section and a three-dimensional image of the brain can be modeled.

Deviations from the norm

Interpretation of the results and diagnosis is formed after a detailed study of the film.

How do the most common pathologies look in the pictures:

  • A large white spot, ragged edges – neoplasm. A tumor compresses adjacent vessels. Disturbed blood circulation in the vascular network is represented by small white spots – a lack of oxygen;
  • Stroke – a bright area in the area of ​​the main vessel. The concentration of the contrast agent in this area is reduced;
  • Cerebral hemorrhage – a dark spot or darkening near the main vessel. Around the spot there is a black border (strip);
  • Atherosclerotic changes – the degree of contrast is reduced, the vessel has an uneven contour;
  • Hypertension – distal neovascular areas have expansion in the picture;
  • Aneurysm – thinning of the vessel;
  • Multiple sclerosis – the destruction of the myelin layer of nerve fibers is reflected in the image in the form of white spots. Completely destroyed areas look like a hearth with multiple white spots. Often these spots are similar to a neoplasm. Conduct control diagnostics – the number of white spots increases;
  • Hydrocephalus – fluid accumulation is reflected by the expanded cavities (ventricles, perivascular and subarachnoid space).

The results of the study reflect various vascular pathologies, including congenital ones. In the pictures, capillary damage is often found – this has absolutely no consequences for the brain. Attention is paid to the integrity of the largest arteries and veins, which are responsible for the delivery of nutrients and metabolic processes.

Only a doctor can examine the picture in detail, given the important nuances (the number of spots, their ratio, shadows and dimming, stripes). The result is a competent result with an authorized diagnosis.

An angiogram of cerebral vessels allows not only to make an accurate diagnosis, but also to evaluate the effectiveness of therapeutic treatment. Based on the results of the study, a decision is made on the advisability of using the surgical method.

Angiography allows you to identify various pathologies and diseases. The main advantages: absolute safety and painlessness, allows you to accurately identify damaged areas of blood vessels and establish the nature of the development of the disease. Obtaining complete and accurate information makes it possible to choose the most accurate and effective treatment. Angiography of blood vessels does not take much time, does not cause discomfort and other unpleasant sensations.

The main indications for angiography of blood vessels:

  • Mechanical, chemical, or burn damage to blood vessels.
  • Stroke.
  • Myocardial infarction.
  • Coronary heart disease.
  • Suspicion of the presence of benign or malignant neoplasms in the blood vessels.
  • Atherosclerosis, aneurysms, blood clots in the blood vessels.
  • Pulmonary embolism.
  • Diabetic foot syndrome.

After the procedure, the patient remains in the hospital for some time, where he is under the constant supervision of doctors. This reduces the risk of complications. The patient is prescribed bed rest, blood pressure and body temperature are regularly measured, and the healing rate of the puncture site is also evaluated.

In some cases, the patient has various kinds of complications:

  • An allergic reaction to a contrast agent introduced during angiography of blood vessels.
  • The appearance at the puncture site of bleeding, swelling and hematomas. Often in this area there are uncomfortable and painful sensations.
  • Impaired kidney function.
  • The development of heart, kidney, or pulmonary failure.

In addition, in the presence of mental disorders, the procedure is performed in exceptional cases, when the risk of not performing angiography is much higher than the procedure. Vascular angiography is not performed during pregnancy and lactation. The exceptions are emergency cases – a stroke, serious injury or other life-threatening condition.

The results of the examination are of great importance for the treatment and prevention of serious diseases. This is information by which doctors can perform an operation in time to save the patient’s life.

Using this modern method, atherosclerosis is detected at different stages of the disease. You can detect aneurysm of the vessels in time and prevent its rupture, which threatens with a stroke. With a hemorrhagic stroke, angiography helps to find the place of hemorrhage in the brain. If there is a tumor on a blood vessel, it is also easy to detect by contrast radiography.

Deciphering the results of angiography should be done by an experienced doctor. Sometimes there are controversial situations when it is difficult to make a decision. In such cases, it is taken by a consultation of medical specialists.

Possible complications

Most patients tolerate the procedure well. In some cases, side effects are observed.

After the introduction of an iodine-containing drug, a metallic taste in the mouth is possible, a sensation of heat spreading to the whole body. In a few minutes it all goes away. When examining the coronary vessels, blood pressure may drop, when touching the aortic catheter, the heart rate may temporarily go astray. Patients also experience a feeling of heat, especially in the face, head.

Complications after angiography are observed in about 5% of cases. First of all, despite precautions, signs of an allergic reaction may appear: redness of the skin, rash (urticaria), respiratory failure. There are known cases of life-threatening complications – anaphylactic shock. With the onset of complications, the patient is provided with emergency medical care.

Sometimes there are cases of bleeding or hemorrhage at the puncture site. In some diseases, this is dangerous with the onset of myocardial infarction. Delayed development of renal and liver failure is also possible. It is important to diagnose them with reference to the patient’s angiography procedure. The danger of these complications is intoxication of the body with iodine residues.

In order for the procedure to go without unpleasant consequences, it is necessary to observe safety measures, conduct a patient examination in advance to take into account all risk factors.

The most common complication of angiography is the entry of contrast medium outside the study area (into the soft tissues, adjacent organs). When you enter an increased dose of the dye, it can lead to damage to the skin and subcutaneous layers, since the procedure for administering the drug already carries the likelihood of swelling, bruising and pain in this area.

A more serious complication is an allergic reaction to a contrast medium. In most cases, it manifests itself quickly enough, with characteristic itching and redness at the injection site, swelling and shortness of breath may occur.

Angiography has a negative effect on the kidneys. Rarely, cases of overlapping arterial lumen with a thrombus, shock, infection, death.

The total risk of complications after or during angiography is no more than 5%.

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Svetlana Borszavich

General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.

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