Name of the Procedure:

Angiography, spinal, selective, radiological supervision and interpretation

Summary

A spinal angiography is a specialized imaging procedure used to visualize the blood vessels in the spine. This technique involves the injection of contrast dye into specific arteries supplying the spinal cord, enabling detailed images to be captured by X-ray.

Purpose

This procedure is used to diagnose and evaluate conditions affecting the spinal blood vessels, such as arteriovenous malformations (AVMs), stenosis, or aneurysms. The goal is to provide a detailed map of the spinal vasculature to guide further treatment and management.

Indications

• Patients with unexplained back pain, weakness, or numbness.
• Suspected spinal vascular issues such as AVMs, aneurysms, or fistulas.
• Pre-surgical planning for spinal surgery.
• Abnormal findings from other imaging techniques, like MRI or CT scans.

Preparation

• Patients may be asked to fast for 6-8 hours before the procedure.
• Blood tests might be performed to check kidney function and clotting profile.
• Medications such as blood thinners might need to be adjusted or paused.
• An IV line will be placed for contrast dye injection and medication administration.

Procedure Description

1. The patient lies on an X-ray table.
2. The area of catheter insertion, usually the groin, is cleaned and numbed with local anesthesia.
3. A small incision is made to insert a catheter into the femoral artery.
4. Under X-ray guidance, the catheter is navigated to the spinal arteries.
5. Contrast dye is injected, and X-ray images are taken.
6. The catheter is removed, and pressure is applied to stop bleeding.
7. The incision is dressed, and the patient is monitored.

Duration

The procedure typically lasts between 1 to 3 hours.

Setting

This procedure is performed in a hospital or specialized radiology center, often in an interventional radiology suite.

Personnel

• Interventional radiologist
• Radiology technologist
• Nurses
• Anesthesiologist (if sedation is used)

Risks and Complications

• Allergic reaction to contrast dye
• Bleeding or bruising at the catheter insertion site
• Infection
• Kidney damage due to contrast dye
• Rare risk of stroke or spinal cord injury

Benefits

• Accurate diagnosis of vascular conditions affecting the spine
• Informs treatment plan and potential surgical intervention
• Can alleviate unexplained symptoms by providing a precise diagnosis

Recovery

• Patients typically lie flat for several hours post-procedure to prevent bleeding.
• Monitoring for any immediate complications.
• Instructions to avoid strenuous activities for 24-48 hours.
• Follow-up appointments to review the results and discuss further treatment.

Alternatives

• Magnetic Resonance Angiography (MRA)
• Computed Tomography Angiography (CTA)
• Direct spinal surgery or minimally invasive endoscopic procedures
• Each alternative has its own set of pros and cons, often involving differences in detail resolution, invasiveness, and risk.

Patient Experience

During the procedure, patients may feel slight discomfort or pressure at the catheter insertion site. Post-procedure, they might experience soreness and need to remain still for a few hours. Pain management is generally effective with over-the-counter pain relievers.