Radiology: Angiography

Question 1

Describe how angiography is performed.

Answer 1

Xrays taken after injection of radiopaque (iodine-based) substance into artery.

Question 2

Describe the vessels through which catheters are inserted, and why.

Answer 2

Femoral:
–it’s big and superficial
–it’s farther from the heart/head - dissection is still a risk but if it happens it’s less dangerous than if it happens at the carotid
–it’s anterior to a big bone, so pressure can be applied against this underlying bone when you’re done and help occlude the big hole you’ve made
Brachial can also be used

Question 3

List some of the major risks to the patient associated with angiography.

Answer 3

• Hematoma from arterial puncture
• Pseudoaneurysm from arterial puncture
• Dissection of artery
• Emboli from catheter/wire manipulation - can dislodge plaque
• Thrombosis and/or emboli
• Contrast allergy/reaction
• Renal compromise from contrast
• Radiation - high levels

Question 4

Describe how regular angiography differs from CT angiography and MR angiography.

Answer 4

CTA: faster; can do venous; you can still see all the other structures; detail not quite as much as angiography

MRA: no xrays/radiation; no dye needed (although you can use it)

angiography: need a sterile surgical suite; takes longer