Aortic angiography

Answer 1

Definition

Aortic angiography is a procedure that uses a special dye (contrast material) and x-rays to see how blood flows through the aorta, the major artery leading out of the heart.

Alternative Names

Angiography - aorta; Aortography

How the test is performed

Before the test starts, you will be given a mild sedative to help you relax.

An area of your body, usually in your arm or groin area, is cleaned and numbed with a local numbing medicine (anesthetic). A radiologist or cardiologist makes a small surgical cut in an artery in the cleansed area, and then inserts a thin hollow tube called a catheter.

The catheter is placed through the artery and carefully moved up into the aorta. The doctor can see live images of the area on a TV-like monitor, and uses them to guide the catheter to the correct position.

Once the catheter is in place, dye (contrast material) is injected into catheter. X-ray images are taken to see how the dye moves through the artery. The dye helps highlight any blockages in blood flow.

How to prepare for the test

You will be asked not to eat or drink anything for 6-8 hours before the test.

The test will be done in the hospital. You may be told to check into the hospital the night before the test. If not, you will be admitted as an outpatient or inpatient the morning of the procedure.

You will be asked to wear a hospital gown and sign a consent form for the procedure.

How the test will feel

You will be awake during the test. You may feel a sting as the numbing medicine is given and some pressure as the catheter is inserted. You may feel a warm flushing when the contrast dye flows through the catheter. This is normal and usually goes away within a few seconds.

You may have some discomfort from lying on the hospital table and staying still for a long time.

Pressure is immediately applied to the puncture site for 10-15 minutes to stop the bleeding. After that time the area is checked and a tight bandage is applied. The leg should be kept straight for an additional 4 hours after the procedure.

Generally, normal activity may be resumed the day after the procedure.

Why the test is performed

Your doctor may order this test if there are signs or symptoms of a problem with the aorta, including:

• Aortic aneurysm
• Aortic dissection
• Congenital (present from birth) problems
  • Double aortic arch
  • Coarction of the aorta
  • Vascular ring
• Injury to the aorta
• Takayasu arteritis

What abnormal results mean

Abnormal results may be due to:

• Abdominal aortic aneurysm
• Aortic dissection
• Aortic regurgitation
• Aortic stenosis
• Congenital (present from birth) problems
  • Double aortic arch
  • Coarction of the aorta
  • Vascular ring
• Injury to the aorta
• Takayasu arteritis

What the risks are

Risks of aortic angiography include:

• Allergic reaction to the contrast dye
• Arrhythmias
• Bleeding
• Blockage of the artery
• Bruising at the site of catheter insertion
• Cardiac tamponade
• Embolism from a blood clot forming at the tip of the catheter
• Heart attack
• Infection
• Injury to the artery
• Low blood pressure
• Stroke

Special considerations

This procedure may be combined with left heart catheterization.

Aortic angiography has been mostly replaced by computed tomography (CT) or magnetic resonance (MR) angiography.

References

Nicholson T, Patel J. The Aorta. In: Grainger RC, Allison D, Adam, Dixon AK, eds. Diagnostic Radiology: A Textbook of Medical Imaging. 5th ed. New York, NY: Churchill Livingstone; 2008:chap 27.

Answer 2

Definition

Aortic angiography is a procedure that uses a special dye and x-rays to see how blood flows through the aorta, the major artery leading out of the heart, and through your abdomen or belly.

Angiography is an imaging test that uses x-rays and a special dye to see inside the arteries. Arteries are blood vessels that carry blood away from the heart.

Alternative Names

Angiography - aorta; Aortography; Abdominal aorta angiogram; Aortic arteriogram

How the test is performed

This test is done in a special unit of the hospital. Before the test starts, you will be given a mild sedative to help you relax.

• An area of your body, usually in your arm or groin area, is cleaned and numbed with a local numbing medicine (anesthetic).
• A radiologist or cardiologist will place a needle into the groin blood vessel. A guidewire and a long tube (catheter) will be passed through this needle.
• The catheter is carefully moved into the aorta. The doctor can see live images of the aorta on a TV-like monitor, and x-rays are used to guide the catheter to the correct position.
• Once the catheter is in place, dye is injected into it. X-ray images are taken to see how the dye moves through the aorta. The dye helps detect any blockages in blood flow.

After the x-rays or treatments are finished, the catheter is removed. Pressure is immediately applied to the puncture site for 20 - 45 minutes to stop the bleeding. After that time, the area is checked and a tight bandage is applied. The leg is usually kept straight for another 6 hours after the procedure.

How to prepare for the test

You will be asked not to eat or drink anything for 6-8 hours before the test.

You will be asked to wear a hospital gown and sign a consent form for the procedure. Remove jewelry from the area being studied.

Tell your health care provider:

• If you are pregnant
• If you have ever had any allergic reactions to x-ray contrast material or iodine substances
• If you are allergic to any medications
• Which medications you are taking (including any herbal preparations)
• If you have ever had any bleeding problems

How the test will feel

You will be awake during the test. You may feel a sting as the numbing medicine is given and some pressure as the catheter is inserted. You may feel a warm flushing when the contrast dye flows through the catheter. This is normal and usually goes away within a few seconds.

You may have some discomfort from lying on the hospital table and staying still for a long time.

Generally, you can resume normal activity the day after the procedure.

Why the test is performed

Your doctor may order this test if there are signs or symptoms of a problem with the aorta or its branches, including:

• Aortic aneurysm
• Aortic dissection
  • Congenital (present from birth) problems
  • AV malformations
  • Double aortic arch
  • Coarctation of the aorta
  • Vascular ring
• Injury to the aorta
• Takayasu arteritis

What abnormal results mean

Abnormal results may be due to:

• Abdominal aortic aneurysm
• Aortic dissection
• Aortic regurgitation
• Aortic stenosis
• Congenital (present from birth) problems
  • Double aortic arch
  • Coarction of the aorta
  • Vascular ring
• Injury to the aorta
• Mesenteric ischemia
• Peripheral artery disease
• Renal artery stenosis
• Takayasu arteritis

What the risks are

Risks of aortic angiography include:

• Allergic reaction to the contrast dye
• Blockage of the artery
• Blood clot that travels to the lungs
• Bruising at the site of catheter insertion
• Damage to the blood vessel where the needle and catheter are inserted
• Excessive bleeding or a blood clot where the catheter is inserted, which can reduce blood flow to the leg
• Heart attack orstroke
• Hematoma -- a collection of blood at the site of the needle puncture
• Infection
• Injury to the nerves at the needle puncture site
• Kidney damage from the dye

Special considerations

This procedure may be combined with left heart catheterizationto look for coronary artery disease.

Aortic angiography has been mostly replaced by computed tomography (CT) or magnetic resonance (MR) angiography.

References

Jackson JE, Allison DJ, Meaney J. Angiography: Principles, techniques (including CTA and MRA) and complications. In: Grainger Rc, Allison D, Dixon AK, eds. Diagnostic Radiology: A Textbook of Medical Imaging. 5th ed. New York, NY: Churchill Livingstone; 2008:chap 6.

Nicholson T, Patel J. The Aorta. In: Grainger RC, Allison D, Adam, Dixon AK, eds. Diagnostic Radiology: A Textbook of Medical Imaging. 5th ed. New York, NY: Churchill Livingstone; 2008:chap 27.

Reviewed By

Review Date: 11/18/2010

David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by Shabir Bhimji, MD, PhD, Specializing in General Surgery, Cardiothoracic and Vascular Surgery, Midland, TX. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.