Angiography

The angiography procedure includes vascular access (puncture of an artery or vein), vessel catheterization (insertion of a catheter — a hollow tube of small diameter into the lumen of the vessel), administration of a contrast agent (most often an iodine-containing solution) and X-ray fixation of vascular images to a digital medium.

Angiography allows you to accurately determine the nature of changes in blood vessels and remains the "gold standard" in the diagnosis of most pathological conditions (atherosclerosis, peripheral vascular diseases, cerebral artery aneurysms, renal artery stenosis, and others).

According to the type of vessels studied, angiography is divided into:

According to the type of visualization technique of the vascular system, traditional angiography is distinguished, href="/programs_and_services/services/klinika-serdca-i-sosudov_mskt-serdca-i-sosudov/">КТ-ангиографию and MR angiography.

There are no absolute contraindications for performing angiography. Even if the patient is found to be intolerant of contrast agents, it is possible to carry out a preliminary hormonal preparation. Relative contraindications for angiographic studies are:

It should be noted that most iodine—containing contrast media are high-viscosity solutions. Their administration is associated with the risk of adverse effects on the kidneys. This is especially true for patients with underlying renal excretory function disorders. For the prevention of contrast-induced nephropathy, additional injection of fluid into the body (hydration) is indicated before angiographic examination.

The preparation of the patient for the study includes the use of at least 2 liters of water without gas a day before the study, as well as the rejection of carbonated drinks and products that cause increased gas formation (legumes, sweet pastries, sweets and sweet fruits). 6 hours before the study, it is necessary to exclude food intake. For example, if the study is scheduled for the morning, a light dinner is allowed. In the morning, you need to drink the pills prescribed by your doctor, washing them down with still water.

To perform angiography, the patient is brought to the X-ray room on a bed, transferred to the operating table, and the intended puncture site is treated with an antiseptic solution. Then the patient is covered with sterile surgical underwear, and the X-ray surgeon proceeds directly to the procedure. After local anesthesia, a puncture of the vessel is performed through which the examination will be performed. A special device is being installed – an introducer (a thin catheter with a hemostatic valve that allows for the replacement of catheters without blood loss). The next step is to insert a catheter of the desired shape and size along a conductor (a special thin string) into the area of interest, and its tip is inserted into the mouth of the vessel under study. A contrast agent is introduced. The images obtained by X-ray radiation are recorded on a digital medium. After that, the catheter and the introducer are removed, and hemostasis is performed (stopping bleeding from the puncture hole). A sterile bandage is applied to the puncture site, and the patient is transferred to the ward under the supervision of the doctor on duty.

If the patient does not have anatomical features that make it difficult to catheterize the vessel under study, angiography lasts 20-40 minutes. Sometimes patients feel the catheter moving through the vessels (especially when using access through the radial artery on the forearm due to the small diameter of the vessel). Some patients feel warmth when contrast is injected into blood vessels. There should be no pain during angiography! If pain, discomfort, or discomfort occurs, the patient should immediately notify the operating surgeon.

Due to the high quality of modern materials from which the instruments are made, modern contrast media and extensive experience in conducting such studies in the world, the percentage of complications during angiography is less than 0.1%.