Extremity arteriography

Answer 1

Definition

Extremity arteriography is a test that uses x-rays and a special dye (contrast material) to see the arteries in the hands, arms, feet, or legs.

Alternative Names

Angiography/arteriography of the extremity

How the test is performed

Extremity arteriography is done in a hospital or medical center. You will lie on an x-ray table. You may ask for a sedative if you are anxious about the test.

The health care provider will shave and clean an area, usually in the groin area. A numbing medicine (anesthetic) is applied, and a needle inserted into an artery. A thin plastic tube called a catheter is passed through the needle, into the artery, and up into the area of the body being studied. The doctor can see live images of the area on a TV-like monitor, and uses them as a guide.

The dye flows through the catheter. X-ray images are taken. The catheter is occasionally flushed with saline solution to help keep blood in the tube from clotting.

Certain treatments can be done during this procedure. They include dissolving a blood clot with medicine, opening a partially blocked artery with a balloon, or placing a small tube called a stent into an artery to help hold it open. These items are passed through the catheter to the site of interest.

The health care team will check your pulse (heart rate), blood pressure, and breathing during the procedure.

After the x-rays are taken, the needle and catheter are withdrawn. Pressure is immediately applied on the leg at the site of insertion for 10 - 15 minutes to stop the bleeding. After that time, the area is checked and a bandage is applied.

The leg should be kept straight for 6 hours after the procedure. You should avoid strenuous activity, such as heavy lifting, for 24 - 48 hours.

How to prepare for the test

You should not eat or drink anything for 8 hours before the test.

You may be told to stop taking certain medications such as aspirin or other blood thinners for a short while before the test. However, do NOT stop taking any medicines unless told to do so by your health care provider. Make sure your doctor knows about all medications you are taking, including all over-the-counter and herbal preparations.

You will be asked to wear a hospital gown and sign a consent form. Jewelery should be removed from the area being studied.

Tell your health care provider if you are pregnant, if you are allergic to any medications, and if you have ever had an allergic reactions to x-ray contrast material or iodine substances.

Also tell the health care provider if you have ever had any bleeding problems.

How the test will feel

The x-ray table is hard and cold, so you may want to ask for a blanket or pillow. There is a sting when the numbing medicine is injected. You may also feel some pressure as the catheter is positioned.

The dye can cause a feeling of warmth and flushing. This is normal and usually goes away in a few seconds.

You may have tenderness and bruising at the site of the injection after the test. If you have swelling, bleeding that doesn't go away, or severe pain in an arm or leg, seek immediate medical care.

Why the test is performed

The test is done when someone has symptoms of blood vessel disease in the arms, hands, legs, or feet. It can help identify and locate:

• Areas of bleeding
• Closings of a blood vessel (occlusions)
• Narrowing of a blood vessel (stenosis)

Normal Values

The x-ray shows normal structures for the age of the patient.

What abnormal results mean

The x-ray may show blockage in the vessels caused by the following:

• Aneurysms
• Blood clots
• Hardening of the arteries in the arms or legs (arteriosclerosis of the extremities)
• Other diseases of the arteries

Abnormal results may also be due to:

• Deep venous thrombosis
• Inflammation of the blood vessels
• Injury to the blood vessels
• Thromboangiitis obliterans

What the risks are

Complications may include:

• Allergic reaction to the contrast dye
• Blockage of blood flow, leading to tissue damage or stroke (rare)
• Clot or bleeding where the catheter entered the artery
• Dissection (separation) of a blood vessel

There is low-level radiation exposure. However, most experts feel that the risk of most x-rays is smaller than other risks we take every day. Pregnant women and children are more sensitive to the risks of the x-ray.