Aortic Angiography

Introduction

Aortic angiography is also known as an angiogram. It is a medical investigation whose aim is to check for the presence of defects or any functional abnormality in the aorta. The aorta is the biggest artery in the body. It originates in the left ventricle of the heart and extends to the abdominal region.  It functions to supply oxygen-rich blood to the entire body. In the course of carrying out this test, the doctor injects a dye into the aorta. This dye makes it visible when an X-ray is used to visualize it thereby detecting possible anomalies with the aorta.

Aortic angiography
Photo Credit: Mount Sinai

Why is an aortic angiography done?

When a doctor thinks that there is an abnormality with the aorta, he would request for an aortic angiography. The possible abnormalities may include:

  • Aneurysm which is a swelling of the aorta due to weakness of the aortic wall
  • Aortic dissection which is when hemorrhage happens in the aortic wall
  • Aortic regurgitation  or aortic stenosis which happens when there is a backflow of blood to the left ventricle
  • Congenital heart defects such as double aortic arch
  • Aortic inflammation called Takayasu’s arteritis
  • Injury to the aorta resulting from accident or other conditions
  • Peripheral artery disease
  • Recurring chest pain

Angiograms are usually done following other non-invasive tests such as computed tomographic scans, magnetic resonance imaging or ultra sound scans.

Risks involved in aortic angiography

Aortic angiography is likened to a surgical procedure which always has risks associated no matter how small. The risks involved with this procedure include a likely infection, excessive bleeding, and blood clotting. Very serious complications are not frequently encountered with angiography. Other likely risks include:

  • Allergy to the dye used
  • Blocking of an artery
  • Blood clot formation
  • Aortic injury
  • Irregular heartbeat
  • Kidney injury
  • Cerebrovascular accident/stroke
  • Arterial tear

Preparing for an aortic angiography

Prior to performing the test, the doctor conducts a complete general physical and systemic examinations. He checks the blood pressure and other vital signs. Be sure to relay to the doctor all drugs and supplements you are on including those bought over-the-counter or prescription-only medicines.

The test usually requires the individual to fast for 12 hours before the procedure. The doctor will advise you to limit the intake of fluids and cessation of intake of drugs that interfere with the coagulation of blood. Because this test may cause a significant amount of pain, the doctor or nurse will administer sedatives or even intravenous anesthesia. Pain relievers are administered to the incision site where the catheter will be inserted and this point located on the groin. You will mostly be awake when the procedure is being carried out.

Performing an aortic angiography

This test involves the injection of a dye by a doctor into the arteries to enable visualization by X-ray. A small cut is being made in the groin and a plastic tube of small length inserted to keep the cut open. A catheter or tube is then inserted via this hole and advanced through the arteries to the aorta.

Pain is absent during insertion of catheter, this is because arteries do not have nerve endings.

When the right site in the aorta is reached, the dye is instilled through the catheter while the doctor monitors its circulation through the arteries on X-ray, checking for any aortic blockade, aortic changes or abnormality in blood flow. The duration taken to perform an angiography is about one hour. Apply pressure to the incision point upon removal of the catheter to avoid excess bleeding. A bandage will also be applied to the site. Another way to prevent bleeding is by lying flat. The patient is transferred to another room to recover. Close monitoring to pick up any complications and giving a liberal amount of fluids to increase dye exit from the body is advised.

After the procedure

The procedure may be conducted as a day case where the patient is free to go home within a few hours after the test was performed. Hospital stay is only indicated where a complication occurred though complications are not common with this procedure.

Proper wound care for the incision site is advised and any further care you need to carry out will be disclosed by the doctor. Bleeding and infection emanating from the infection sites are usual complications of the test. Stay away from driving or carrying heavy loads for some days. Recovery is usually fast and one soon resumes routine activities.

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