Angiography – Treatment, Effect & Risks

application and function

Angiography is suitable for different areas of application. It is primarily used to determine changes in the vessels such as malformations, stenoses (narrowing) or occlusions. Angiography can be used to diagnose circulatory disorders or blood clots ( thrombosis ).The procedure also plays an important role in the treatment of vessels prior to surgical interventions or in the diagnosis of tumors . Angiography can also be used to monitor drug therapy to dissolve a blood clot or vascular surgery.

In earlier times, angiography was performed exclusively for examination purposes. In the meantime, however, minimally invasive interventions have also become an important part of the procedure. It is used to treat blood vessels in the same way as with balloon dilatation, in which narrowings or blockages are repaired within the vessel with the help of a small balloon.

By using a catheter, so-called stents (vascular supports) can also be implanted in order to treat narrowed or blocked vessels. Blood clots can also be treated with angiography, in that the doctor introduces medication via a catheter that ensures that the clot dissolves.

As part of a tumor treatment, the tumors are fought by obliterating the tumor-supplying arteries with simultaneous chemotherapy . In addition, an angiography can be performed at the same time as surgery, which doctors call hybrid surgery.

methods and procedures

Angiography includes different methods that depend on the respective vessels. This includes, among other things, the arteriography, which can be carried out via a groin or elbow artery. After the puncture, a narrow wire is advanced into the vascular system under X-ray control. A contrast medium is injected using a catheter.

Small interventions are also possible. Phlebography is when the veins are visualized. The doctor punctures smaller veins on the back of the foot or the back of the hand . Digital subtraction angiography is performed using a special computer program that is used for analysis.

Angiography also includes CT angiography and MR angiography, which are based on computed tomography or magnetic resonance imaging. After injecting a contrast medium into a vein, the vessels can be displayed in three dimensions.

What does the patient have to consider?

Before an angiography is performed, the doctor informs the patient about the procedure of the examination as well as possible risks and alternative examinations. Of particular importance are certain previous illnesses of the patient, about which the doctor must know. For example, an angiography should not be performed in the case of diseases of the thyroid gland , allergies or kidney failure . In order to rule out such symptoms, the doctor carries out a blood test in which the blood values ​​and blood clotting of the patient are checked.

Following the angiography, it is important that the patient drinks plenty of fluids and stays in bed. Drinking allows the contrast medium to be eliminated from the body more quickly. Heavy physical activities should be avoided on the day of the examination. If you experience nausea , tachycardia or dizziness , you should see a doctor immediately.

process and implementation

At the beginning of the angiography, which takes between 15 and 30 minutes, the patient is given a local or general anesthetic . In conventional angiography, the doctor inserts a thin plastic tube, which is the catheter, into the vessel to be examined. The catheter comes to a standstill just before the section of the vessel to be examined.

The doctor then administers the contrast medium, which gets into the vessels. On the X-ray image, the contrast medium takes on a white color because the X-rays are absorbed by it. In this way, the interior of the vessel can also be recorded on the angiogram.

After the end of the X-rays, the catheter is removed and a pressure bandage is applied to the puncture site. The pressure bandage has the function of counteracting secondary bleeding. Typically, the patient must wear the bandage for 12 to 24 hours. He should also stay in bed for four to twelve hours.

Digital subtraction angiography is a special form of angiography. The X-rays are taken both before and after the administration of the contrast medium. The identical image areas are removed by a computer, which reveals clear changes in the vessels that are filled with the contrast agent.

In CT or MR angiography, the contrast medium is not injected directly into the vessel to be examined. Instead, your doctor will give it into an artery or vein in your arm. No contrast agent at all is required for a so-called TOP angiography (time-of-flight MR angiography), because due to magnetization, the images can be made visible through the freshly flowing blood.

The special angiography forms have the advantage that they do not require a catheter. Ultimately, the method to be used depends on the nature of the questions.

Self-service or health insurance – who bears the costs?

Statutory health insurance companies cover the costs of an angiography. The prerequisite is, of course, the medical necessity of the procedure.

Risks, dangers and complications

Angiography is considered a method with few risks. The radiation exposure during the examination is also classified as low. However, some side effects are sometimes possible. These can be injuries or bruises at the puncture site, temporary feelings of tension in the heart region, inflammation, cardiac arrhythmias or circulatory disorders .Sometimes there are hypersensitivity reactions to the administered contrast medium, which can be noticed by a skin rash , itching , nausea or sneezing.