Angiography/arteriography of the extremity

Definition

Extremity arteriography is a test to see the arteries in the hands, arms, feet, or legs.

Alternative Names

Why the Angiography/arteriography of the extremity 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)

How the Angiography/arteriography of the extremity is Performed

This test uses x-rays and a special dye (contrast material) to make blood vessels show up on the images.

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After the x-rays are taken, the needle and catheter are withdrawn.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 Angiography/arteriography of the extremity

You should not eat or drink anything for 8 hours before the test. Some medications, such as aspirin or other blood thinners, may need to be stopped for a while before the test. However, do NOT stop taking any medicines unless told to do so by your health care provider.

You will be asked to wear a hospital gown and sign a consent form for the procedure. Jewlery should be removed from the area being imaged.

Tell your health care provider if you are pregnant, if you have allergies to any medication, which medications you are taking (including any herbal preparations), and if you have ever had any 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 Angiography/arteriography of the extremity 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 anesthetic is given. This does not numb the artery, so you will feel a brief, sharp pain as the catheter is inserted. There is a feeling of pressure as the catheter is advanced. As the dye is injected, you may experience a burning sensation.

There may be tenderness and bruising at the site of the injection after the test. If you experience an enlarging mass, recurrent bleeding, or significant pain in the extremity, seek immediate medical attention.

Risks

Complications may include:

• Allergic reaction to the contrast medium (dye)
• Rarely, a blood clot that blocks blood flow, leading to tissue damage or stroke
• Clot or bleeding at the puncture site

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.

Normal Results

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:

• Hardening of the arteries (arteriosclerosis) or other diseases of the arteries
• Blood clots
• Aneurysms (sacs filled with blood that have formed because of an abnormal widening in the artery)

Additional conditions under which the test may be performed include the following:

• Deep venous thrombosis
• Thromboangiitis obliterans
• Vasculitis
• Trauma

Extremity arteriography may also be used before surgery.

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