Angiography is a method of visualising the body vessels. By administering a contrast agent into the vein, which makes the veins visible, radiograms called DSA are obtained with the help of special X-ray devices. Thanks to angiography, the vessels supplying the organs are visualised and diagnostic information about vascular diseases or organs supplied by these vessels is obtained. In addition, angiography is also used for therapeutic purposes in line with the information obtained. Angioplasty (opening narrowed vessels with a balloon) is an example of this. With this method, treatment is possible without the risks of surgery and general anaesthesia.
In the diagnosis of cardiovascular diseases, especially in emergency situations such as sudden heart attacks, angiography is an important life-saving examination method. Angiography, which shows the problems in the vessels leading to the heart, is performed in the following cases; the patient has severe chest pain, the patient has a risk of heart attack, the patient shows signs of coronary stenosis, the patient’s effort test is positive, the patient’s heart contractions start to be irregular during echo, in the presence of heart valve disease, angiography is used to check the patient’s final condition after bypass.
On the other hand, there are those who recommend coronary angiography in patients over the age of 40 who will undergo a major operation in order to show the durability of the vessels in the heart for such an operation.
After a heart attack, angiography is performed at routine check-ups. In addition, angiography is performed to evaluate diseases of the heart vessels, diseases of the heart valve, the function of the heart muscle and to plan their treatment. Blockages in the heart vessels can also be detected by angiography.
How is angiography performed?
The main purpose of angiography is to visualise the vessels in the heart in detail. For this reason, in order to perform the procedure, the arteries are entered through the right groin, right and left wrist or armpit area and advanced towards the heart.
During angiography, a catheter is used to prevent damage to the artery and the formation of a clot. The catheter is a thin tube and can easily enter the vein and reach the arteries. By injecting a contrast medium into the artery, the image obtained becomes more meaningful and is recorded on the computer. The imaging process in angiography can also be performed in the following ways; Intravascular Ultrasonography (IVUS, Optical Coherence Tomography (OCT), Fractional Flow Reserve (FFR)
Preparation for Angiography
The duration of angiography varies according to the procedure performed. In a normal patient, angiography is a short procedure lasting between 10 and 15 minutes. However, for people who have previously undergone Bypass, this may take 20 to 30 minutes. After angiography, the catheter entered into the patient’s vein is pulled out after the procedure is finished and pressure should be applied for a certain period of time to stop the bleeding with clean cotton with alcohol. After the bleeding of the patient who has undergone angiography stops, a bandage is wrapped around the angiography site and a weight is applied, the patient is hospitalised in the hospital for 4 to 6 hours and the patient is rested. In some patients, discharge procedures are initiated one day after the angiography procedure.
Before angiography, the patient is dressed in a special gown and the patient is placed on the angiography table. Following skin cleansing, preferably from the right groin, the vessels are visualised by entering into the artery or vein with the help of a special catheter after local anaesthesia. The patient does not feel the procedure as local anaesthesia is administered at this time.
- Visualisation of the vessels of the arms and legs
- Visualisation of intra-abdominal organ vessels
- Visualisation of brain vessels
- Visualisation of pulmonary vessels
After Angiography Procedure
The night before the angiography procedure, nothing should be eaten or drunk except for the medicines that must be taken in the morning. If blood thinners (aspirin, coumadin, etc.) are used, the relevant physician should be consulted before the procedure. Knowing the kidney functions of the patient before the procedure is also important due to the use of contrast. In addition, pubic hair cleaning should be done before the procedure.
Imaging of the Heart Vessels
Angioplasty: It is performed to reopen narrow or completely blocked arteries with special devices called balloons or stents. Blockages in the leg veins, blockages in the renal arteries causing high blood pressure and blockages in the vessels supplying the brain can be treated non-surgically by radiologists in this way. An important advantage is that general anaesthesia is not required.
Angio Embolisations: It is the process of blocking the vessels of abnormal vascular tangles, bubbles formed in the vessels or cancer tissues with abnormal blood supply in various ways. It is mainly used to occlude the most common causes of cerebral haemorrhages, namely, the bubbles formed in the vessels and the abnormal vascular tangles called AVMs. The method is used in the treatment of cancer tissues, especially liver cancers, by blocking the abnormal vessels by means of angiography. With these procedures performed by radiologists, some diseases are treated with local anaesthesia and angiography. However, these treatment methods also have certain risks as in surgical treatments.
Bed rest is required for 12-24 hours after the procedure. (For angiography, hospitalisation is required for the first 6 hours.) Vital signs are checked at regular intervals. The bandage over the access site is kept on for 24 hours.