Atrium Health Navicent Heart & Vascular Care
What Is an Arteriogram?
A diagnostic arteriogram or aortogram is a minimally invasive test that allows a physician to map out a patient's arteries. It provides a schematic for the physician to perform a medical procedure involving those arteries, like surgery, angioplasty, inserting a stent, and many others.
How is a diagnostic arteriogram or aortogram with or without intervention performed?
The first step to performing a diagnostic arteriogram or aortogram is to dye the body's circulatory system through an intravenous access. The dye will help the X-ray image distinguish between the arteries and the rest of the body by rendering the arteries opaque. A trained physician can then read the structure of the blood vessels and make a diagnosis or plan a procedure. This also allows physicians to be specific with the arteries they wish to examine more closely by choosing the artery to dye. The procedure of choosing a specific artery is called super selective angiography.
Before the catheter used to dye the artery or arteries is inserted, the patient is put under local anesthesia, which numbs the access site. Depending on the area the physician has chosen as an access site, the patient may or may not require general anesthesia. Infants, young children, or patients who are anxious may also be put under general anesthesia.
A diagnostic arteriogram or aortogram with or without intervention differs depending on the body part or system and the purpose of the test. A physician will more carefully discuss the specifics of the procedure with his or her patient.
Generally, however, arteriograms and aortograms follow certain similar processes across the board.
The patient generally on an X-ray table and is positioned for access to the body part or system being examined.
An intravenous line will be inserted into a blood vessel, usually in the patient's arm or hand, though this may vary depending on the procedure.
The patient is then connected to an electrocardiogram (ECG) monitor that helps to monitor the activity of the heart. Small, adhesive electrodes are placed onto specific parts of the patient's body so that vital signs like heart rate, blood pressure, and breathing rate can be monitored.
A small incision, creating an access point, is made in a major blood vessel. Physicians usually choose the arm or the groin, which allows for easier access to the area they are interested in. A catheter is then threaded into the access point and directed to the necessary area.
Ink is fed into the catheter once it is in place, and a series of X-rays is taken.
With the necessary X-rays finished, the catheter is removed and pressure is placed on the access site to prevent bleeding. The patient will have to remain flat in bed in the hospital for several hours before bleeding stops completely.
Once discharged patients must keep a close watch on the insertion side for bleeding, unusual pain, or swelling. Discoloration or temperature change in the puncture site may also be an indication of complications. Bruising is normal.
Patients are advised not to do strenuous activities for the next three days and cannot take hot baths or showers for a week.
What Is a Diagnostic Arteriogram or Aortogram Used For?
An arteriogram or aortogram may be performed to detect any abnormalities in the blood vessels or the aorta. The most common issues are aneurysms, the narrowing of blood vessels, spasming of the blood vessels, arteriovenous malformation, thrombosis, or occlusion.
Any abnormal connection between arteries and veins, blockages, or clots can be detected accurately with a diagnostic arteriogram or aortogram with or without intervention.
Often, an arteriogram is recommended after a previous procedure that indicates a possible complication that requires more information.
Sometimes, if a condition is detected, the physician may intervene directly. Treatments that may be done during an arteriogram include dissolving a clot or placing a stent in a blood vessel.
What Is the Recovery Process from a Diagnostic Arteriogram or Aortogram with or without intervention?
The radiologist will always discuss the results of the examination with the patient's primary care physician after the procedure. Because of this, the patient can be ushered to his or her hospital room, where the nursing staff with support and help the patient is comfortable. The patient is required to lie flat for the next several hours. If the patient is not planning to stay overnight, he or she must have a family member or friend drive him or her home.
Once the patient has gotten home, he or she should plan to relax for the next day or so. A normal diet and dosage of medications can be resumed. As usual, the patient should aim to drink plenty of fluids.
The patient should keep the entry site bandaged for the next 24 hours as well, and not enter the hot water for the next 12 hours. Strenuous activity or lifting heavy objects should not be performed for the next two days.
What Are the Possible Complications from an Arteriogram or Aortogram?
As with all medical procedures, diagnostic arteriograms or aortograms with or without intervention come with certain risks.
Bleeding may occur where the catheter was inserted. In this case, heavy pressure must be applied to the area to staunch the bleeding.
Numbness, coolness, or other changes in temperature at the access site can be a sign that blood vessels have not healed properly, and the patient should contact his or her physician.
Overall, diagnostic arteriograms and aortograms are very safe and complication rates are extremely low across all demographics.