DefinitionAortic 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 NamesAngiography - aorta; Aortography; Abdominal aorta angiogram; Aortic arteriogram
How the test is performedThis 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 testYou 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 pregnantIf you have ever had any allergic reactions to x-ray contrast material or iodine substancesIf you are allergic to any medicationsWhich medications you are taking (including any herbal preparations)If you have ever had any bleeding problems
How the test will feelYou 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 performedYour doctor may order this test if there are signs or symptoms of a problem with the aorta or its branches, including:Aortic aneurysmAortic dissectionCongenital (present from birth) problemsAV malformationsDouble aortic archCoarctation of the aortaVascular ringInjury to the aortaTakayasu arteritis
What abnormal results meanAbnormal results may be due to:Abdominal aortic aneurysmAortic dissectionAortic regurgitationAortic stenosisCongenital (present from birth) problemsDouble aortic archCoarction of the aortaVascular ringInjury to the aortaMesenteric ischemiaPeripheral artery diseaseRenal artery stenosisTakayasu arteritis
What the risks areRisks of aortic angiography include:Allergic reaction to the contrast dyeBlockage of the arteryBlood clot that travels to the lungsBruising at the site of catheter insertionDamage to the blood vessel where the needle and catheter are insertedExcessive bleeding or a blood clot where the catheter is inserted, which can reduce blood flow to the legHeart attack orstrokeHematoma -- a collection of blood at the site of the needle punctureInfectionInjury to the nerves at the needle puncture siteKidney damage from the dye
Special considerationsThis procedure may be combined with left heart catheterization to look for coronary artery disease.Aortic angiography has been mostly replaced by computed tomography (CT) or magnetic resonance (MR) angiography.
ReferencesJackson 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.