Blood vessels are visualised using different radiological methods. Ultrasound, CT or MR examinations are sufficient in some cases, as – in most cases – these methods detect different abnormalities, vascular malformations, vascular injuries, blood clots, vessel occlusions, narrowings and aneurysms. However, in certain cases, performing catheter angiography for the visualisation of vessels is inevitable.
Nowadays, catheter angiography is most often performed prior to interventions (treatment with special catheters, without open vascular surgery) and for the precise planning of operations. Catheter angiography aims to visualise the vessels of the limbs, the main artery, and the large vessels of the abdomen, the neck or the skull.
Every age group can be examined with angiography; however, narcosis or anaesthesia might be necessary in some cases. The written consent of one of the parents’ of the under-aged, and the closest relative, guardian or the referring physician for unconscious or mentally unstable patients is required to perform the examination.
An angiography examination is performed under operating conditions in a supine position. The catheter is usually introduced through the artery in the area of the groin or the elbow, after local anaesthesia. The catheter is stopped at the start of the vessel section to be examined, and the contrast medium is injected directly into the vessel to be examined. The modern contrast media we use only cause little burden for the body and are excreted in the urine. Images are made during the examination, and afterwards, the catheter is removed. The examination usually lasts 40 to 60 minutes including the preparation.
The puncture site should be compressed until the bleeding stops, after which a compression bandage is applied, which has to be kept in place for 6 to 24 hours depending on the puncture site and the thickness of the catheter used. If the artery in the groin was punctured, strict bed rest is required for at least 24 hours after the examination. Extensive fluid intake is recommended after the intervention to remove the contrast medium as soon as possible. Your physician will decide when you can go home based on your clinical condition. Smoking is forbidden for at least 24 hours. You should not lift anything or drive a car for two days. If you experience bleeding at the puncture site or the catheterised limb becomes painful or discoloured, immediately call an ambulance.
Using modern techniques, angiography is a safe procedure; however, the introduction of a catheter into the vessel through which contrast medium is given entails some risk factors. A bruise often develops at the puncture site, but disappears in a short time. When the catheter is introduced, the wall of the vessel might be damaged, and bleeding or vascular occlusion might occur. Serious complications (shock, death) are extremely rare, and are usually caused by the simultaneous illness of several vital organs. During pregnancy, the intervention can only be carried out if a serious disease is suspected, because X-rays may harm the foetus.
The contrast medium might cause hypersensitivity or an allergic reaction in some patients during the angiography examination, which is mild in most cases (nausea, urticaria, chills, blood pressure drop). These rare, mild complaints resolve within a few minutes, or can be terminated easily with medications. It is extremely rare, but hypersensitivity with respiratory and circulatory collapse may also occur. Treatment of these potentially fatal conditions requires intensive care. We provide our patients the medications, tools and the clinical background needed to treat any contrast medium-related hypersensitivity.
In summary, diagnostic angiography is more unpleasant than painful. The injection of local anaesthetics – similarly to other punctures – causes a painful, tense and stinging sensation. When the contrast medium is injected, a warm sensation presents in the areas where the contrast medium passes through, which the patient – depending on his/her condition – might experience as hot, painful or just pleasantly warm.
Catheter angiography is only performed on a specialist’s referral, on the expense of the public health insurance. General practitioners cannot issue a referral for the examination. The booking time is 3 to 10 days.
The examination cannot be requested in the form of private care.