Angiography: what is it, the description of the procedure and the features of the

Patients suffering from heart and vascular diseases undergo regular clinical studies. Primary diagnosis allows you to differentiate pathology and make a correct diagnosis, and examinations in dynamics help to clarify the state of the body during the period of therapy and are a preventive measure for the development of complications. A commonly used method for examining diseases of the cardiovascular system is angiography. What is diagnostically important is shown by manipulation and how it is carried out, is considered in the article.

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The realization of the idea of the appearance of angiography took more than 30 years since the physiologist Bekhterev voiced his idea: "If solutions exist that do not miss the rays of the X-ray, then such liquids can be filled with vessels and photographed." In order for manipulation to become widespread and effective in use, it took another four decades.

The patients who are prescribed the procedure are interested in: "Angiography - what is it?" This is a method of diagnosing the condition and patency of vessels, which is carried out using radiopaque substances. The procedure allows you to evaluate the following indicators:

• Blood flow velocity;
• The location of the vessels;
• Presence of congenital anomalies;
• Narrowing;
• Formation of roundabout bloodways;
• The state of the vessels that nourish the tumor.

Where is the procedure performed?

Diagnostic centers (narrow or wide profile) and hospitals are equipped with special facilities for angiography.

All the conditions of asepsis are met here. The rooms have the necessary equipment:

• Angiograph - a device that has an X-ray unit for assessing the condition of blood vessels (arteries, veins, capillaries, lymphatic vessels);
• High-speed fluorography chamber;
• The device, the task of which is to perform X-ray multishooting and video recording.

In highly specialized diagnostic institutions, CT angiography is performed. This procedure allows you to get a clearer picture of the state of the vessels (in details), and therefore requires the use of advanced advanced devices.

Principles of research

In this blood vessel, which is necessary to examine and study, introduce an X-ray contrast substance, which is an iodine derivative. This is done by catheterization or puncture. If the vessel is located a short distance under the skin, then the solution is injected with a syringe (puncture).

Catheterization is used for deeper arteries or veins. In the projection of the test vessel, local anesthesia is done. After cutting the skin and subcutaneous fat, the test vessel is found, an introducer is introduced into it (a thin tube of plastic about 10 cm in length). Through the introducer move the remaining tools and catheter to accidentally not damage the walls of blood vessels. A contrast agent is injected through the catheter.

After the solution enters the vessel, it spreads through the system. First, arteries and veins are filled, then arterioles, venules and capillaries. At this time, with the help of an X-ray machine, take a few shots or take a short video.

The performed angiography of the arteries or veins (the results of the study) is fixed on a digital medium, which allows to show the manipulation data to other specialists.

Where is it applied?

The examination of the condition and patency of the vessels is used in such areas of medicine as:

• Vascular surgery - before surgery, the doctor specifies the location and structure of the operated zones;
• Oncology - the area of the primary area and metastases is inspected at the time of construction of their capillary network;
• Pulmonology - allows you to evaluate the vascular network of the lungs, as well as to determine the localization of bleeding;
• Phlebology - specialists determine the presence of constrictions, the appearance of aneurysms, the formation of thrombi, the vascular lesions of atherosclerosis, anomalies of an innate nature;
• Neurology - angiography of the vessels of the brain shows the presence of aneurysms, hemorrhages, narrowing, tumor processes.

If it is necessary to examine all the vessels of a certain area, then this procedure is called general angiography. In the case of assessing the state of individual vessels, such a study is called selective.

Angiography of cerebral vessels

For the examination, the radiopaque substance is administered by catheterization of one of these arteries, such as:

• Right femoral;
• Shoulder;
• Ulnar;
• Subclavian.

The catheter is advanced along the blood vessel system to the area where the branch of the test vessel is located. A solution is introduced into its lumen. Immediately make a series of pictures on the side and front of the head. If it is necessary to study more distant structures, a second portion of the substance is introduced. Again, a series of images in the required projections follows. The entered instruments are deleted, and the diagnostics are considered complete.

Angiography of the brain requires the use of local anesthesia to anesthetize the place where the catheterization is performed. While the catheter is being pushed through the body, the patient does not feel any discomfort. With the introduction of the solution, the taste of metal in the mouth, hyperemia of the facial skin, sensation of diffuse heat may appear. The phenomena disappear after a few minutes.

Indications for examination of cerebral vessels

A number of pathological conditions requiring diagnosis (for the specification of details, MRI angiography is performed):

• An aneurysm - an expansion of the vessel, which can lead to hemorrhage;
• Angioma - vascular tumor;
• Stroke ischemic nature - the doctor evaluates the need for thrombolysis;
• Stroke hemorrhagic character - the source of hemorrhage is determined;
• Malformation of blood vessels - the doctor evaluates the level of pathology and source of bleeding;
• CCT - allows you to determine the consequences of injury;
• Hematoma - the expert estimates the localization and size;
• Tumor - determine the size, location, the state of feeding vessels.

Angiography of the vessels of the heart

Coronary angiography - what is it? This is a method of examining the blood vessels of the heart. The femoral or radial artery is catheterized and the catheter is carried to the aorta. Radiocontrast solution is injected alternately into the right and left coronary arteries. A series of pictures is done instantly.

The patient may complain of the appearance of such symptoms when the drug is administered, such as:

• Fever in the face;
• arrhythmia;
• dizziness;
• nausea, vomiting;
• cough.

Indications for the conduction are infarction, coronary heart disease, cardiosclerosis, congenital heart anomalies.

Study of the vessels of the extremities

Angiography of the extremities involves the process of examining the condition of the arteries and veins of the hands and feet. Diagnosis of the upper limbs is carried out by introducing an X-ray contrast material into the brachial artery. For the lower limbs - in the abdominal aorta or femoral artery, depending on which level of diagnosis is required. To study the vessels of the foot and shin, a puncture of the posterior tibial artery is performed. When the solution is administered, the patient can feel a rush of heat in the legs.

Indications for research:

• Atherosclerosis of the lower extremities;
• Obliterating endarteritis;
• Thrombosis, thrombophlebitis;
• Thromboembolism;
• Damage accompanied by rupture of blood vessels;
• Exfoliating aneurysm;
• Evaluation of treatment effectiveness.

Preparation for diagnosis

It is necessary to clarify the lack of individual hypersensitivity to iodine and its derivatives. If the patient has a pregnancy, X-rays are not used. In this case, MR angiography is preferable.

For two weeks exclude alcoholic beverages, for a week - anticoagulants ("Heparin", "Warfarin", "Aspirin"). A few days before the diagnosis, a number of studies are carried out, such as:

• Clinical analysis of blood and urine, coagulogram, biochemistry;
• ECG and ultrasound of the heart;
• Fluorography of the lungs;
• Determination of the blood group and Rh factor;
• Tests for infection (HIV, hepatitis, syphilis).

On the eve of angiography, a test is made for the radiopaque substance. Enter 0.1 ml of the solution into the vein. In case of urticaria, allergic rhinitis, conjunctivitis, arrhythmia, the drug should not be used.

In the evening before the procedure, a cleansing enema, hygienic procedures are performed. The specialist prescribes sedatives that allow you to relax and rest the patient. In the morning, the subject should not eat or drink, before manipulation, the bladder must be emptied.

Nuances of preparation

There are a number of pathological conditions that require a longer and more thorough approach in preparing for such a procedure as angiography. What do patients need to do to make the diagnosis go without complications?

At high arterial pressure it must be stabilized. To this end, use "Nifedipine", "Dibazol", "Raunatin" or any other antihypertensive drug that is in constant therapy of the patient.

In the presence of violations of the heart rhythm, enter "Panangin" or potassium chloride. By appointment, the doctor uses cardiac glycosides. With IHD or heart pain syndrome use "Nitroglycerin", "Erinit", "Sustak".

Kidney disease requires saturation of the body with water. The radiopaque substance used will less act as an irritant and be excreted more quickly from the body with urine.

If there are chronic sources of infection (sinusitis, bronchitis), a specialist prescribes antibacterial drugs or sulfonamides 2 weeks before the test.

Contraindications to angiography

Diagnostic procedure is not performed when there is a threat to the condition and health of the patient. This occurs under conditions such as:

• Acute inflammatory diseases;
• psychical deviations;
• Kidney failure;
• Heart failure in the stage of decompensation;
• Allergy to iodine and its derivatives;
• Diseases accompanied by a violation of blood clotting;
• pregnancy.

Angiography is an effective and widely used method of studying the vascular system, which has a lot of advantages over other diagnostic manipulations.