Interventional radiology angiogram

Overview

An interventional radiology angiogram is a procedure that uses special X-ray images and a thin, flexible tube called a catheter to look at your blood vessels and treat certain problems without major surgery. It is done by a doctor called an interventional radiologist.

Angiograms are a common radiology procedure, with many performed every year to diagnose and treat blood vessel problems.

Anyone who has symptoms of a blocked or bleeding blood vessel may need an angiogram. It is often used for people with chest pain from heart disease, leg pain from peripheral artery disease, or a sudden bleed.

Symptoms

Common symptoms

• Chest pain or discomfort
• Leg pain when walking (claudication) that goes away when resting
• Shortness of breath
• Sudden severe headache (possible aneurysm or bleed in the brain)

Symptoms in children

• A child may need an angiogram if they are born with a heart defect or have a blood vessel problem, such as a narrowing or abnormal connection.

Symptoms in older adults

• Older adults may have more complex blockages or fragile vessels. They might have symptoms like pain in the legs or feet, or a history of stroke or heart attack.

Causes

Main causes

• Atherosclerosis – buildup of fatty plaques inside arteries
• Blood clots that block a vessel
• Aneurysm – a bulge in a blood vessel that can burst
• Injury that damages a blood vessel

Risk factors

• Tobacco smoking or vaping
• High blood pressure
• High cholesterol
• Diabetes
• Being overweight
• Not being active enough
• Older age

When to see a doctor

See a doctor urgently if:

• If you have sudden chest pain or difficulty breathing, call your local emergency number immediately.
• If you have sudden weakness, numbness, or trouble speaking, get emergency help right away.

Book a routine appointment if:

• If you have leg pain when walking that goes away when you rest, talk to your doctor.
• If you have been told you have risk factors for blockages, discuss whether a screening angiogram might be helpful.

Diagnosis

Before an angiogram, your doctor will do a physical exam and take a full medical history. They may also order other tests, like an ultrasound or CT scan, to decide if an angiogram is needed.

Tests that may be done

• Doppler ultrasound – shows blood flow in your vessels
• CT angiogram (CTA) – a special CT scan that shows blood vessels
• Magnetic resonance angiogram (MRA) – uses a magnet to create detailed images

What to expect at your appointment

You will be asked to lie on a table. The area where the catheter will go is numbed. A very thin tube is moved through an artery while the doctor watches X-ray pictures on a screen. You may feel pressure but not sharp pain. The procedure usually takes 30 minutes to 2 hours.

Treatment

An interventional radiology angiogram can both diagnose and treat problems during the same procedure. If a blockage or narrowing is found, the doctor may use tiny tools to open the vessel or repair it.

Self-care at home

• After the procedure, rest and keep the puncture site clean and dry.
• Do not lift heavy objects or do strenuous activity for a few days, as advised by your doctor.
• Drink plenty of water unless your doctor tells you otherwise.

Medical treatments

Treatments during an angiogram can include balloon angioplasty (inflating a small balloon to open a narrowed vessel), placing a small mesh tube called a stent to keep the vessel open, or injecting medicine to dissolve a clot.

When is surgery considered?

Major surgery is rarely needed if an angiogram can be used. But if the blockage is very long or complex, or if a stent fails, you may need bypass surgery.

Living with this condition

After an angiogram, most people return to their normal routine within a week. You may have a small bruise or lump where the catheter was inserted, which usually goes away on its own.

Lifestyle tips

• Stop smoking or vaping – this is very important for your blood vessels.
• Keep to a healthy weight and be physically active as much as possible.
• Manage any other health conditions like diabetes or high blood pressure.

Diet and exercise

Eat plenty of fruits, vegetables, whole grains, and lean protein. Limit salt, sugar, and processed foods. Aim for at least 150 minutes of moderate activity each week, like brisk walking.

Mental health and emotional wellbeing

Waiting for a procedure or results can be stressful. Some people feel anxious. It is normal to have questions. Talk to your care team and reach out to friends or family for support.

Prevention

You can lower your risk of needing an angiogram by keeping your blood vessels healthy. This means not smoking, eating well, staying active, and managing conditions like high blood pressure and diabetes.

Screening programmes

Some people may benefit from screening tests if they have risk factors. Talk to your doctor about whether a screening is right for you.

Complications

If left untreated

• A blocked artery can lead to heart attack, stroke, or limb damage.
• An aneurysm can burst and cause life-threatening bleeding.
• A blood clot can travel to the lungs and cause pulmonary embolism.

Long-term outlook

Most people who have an angiogram do very well. The procedure is safe and effective, and it often improves symptoms quickly. With good follow-up care and lifestyle changes, many people live healthy lives.

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