Name of the Procedure:

Angiography, Extremity, Bilateral, Radiological Supervision and Interpretation

Summary

Angiography of the extremities is an imaging procedure used to visualize the blood vessels in both legs or arms. It involves injecting a contrast dye and capturing X-ray images to detect any abnormalities.

Purpose

Medical Condition: Used to diagnose conditions like peripheral artery disease (PAD), blood clots, or aneurysms.

Goals:

• Identify blockages or narrowing of blood vessels.
• Assess blood flow and vascular health.
• Guide surgical or interventional treatment plans.

Indications

• Symptoms of PAD such as leg pain while walking or at rest.
• Non-healing wounds on the extremities.
• Suspected blood clots or aneurysms.
• Abnormal findings in other vascular tests like duplex ultrasound.

Preparation

• Fasting: Typically, no eating or drinking for 6-8 hours before the procedure.
• Medications: You may need to adjust or stop certain medications (e.g., blood thinners) as directed by your doctor.
• Diagnostic Tests: Pre-procedure blood tests, kidney function tests, and sometimes an ECG.

Procedure Description

1. Sedation/Anesthesia: Local anesthesia is usually applied; sedation may be used if necessary.
2. Access Point: A small incision is made near the groin, wrist, or arm.
3. Catheter Insertion: A thin, flexible tube (catheter) is inserted into the artery.
4. Contrast Dye Injection: Contrast dye is injected through the catheter to make blood vessels visible on X-ray images.
5. Imaging: A series of X-ray images are taken to capture detailed views of the blood vessels in both extremities.
6. Catheter Removal: Once images are captured, the catheter is removed, and the incision site is bandaged.

Duration

Typically takes about 1 to 2 hours.

Setting

Performed in a hospital's radiology or catheterization laboratory.

Personnel

Generally involves an interventional radiologist, radiology technologists, and nursing staff.

Risks and Complications

Common Risks:

• Bruising or bleeding at the catheter insertion site.
• Allergic reaction to the contrast dye.

Rare Complications:

• Infection.
• Kidney damage from the contrast dye.
• Blood vessel damage or clot formation.

Management includes monitoring and prompt medical intervention if complications arise.

Benefits

Provides detailed images of blood vessels, helping in accurate diagnosis and treatment planning. Benefits are typically realized immediately upon diagnosis.

Recovery

• Post-Procedure Care: Pressure is applied to the insertion site to prevent bleeding.
• Observation: Short period of monitoring, usually a few hours.
• Activity Restrictions: Limited physical activity for 24-48 hours.
• Follow-Up: Scheduled follow-up to discuss results and any further treatment.

Alternatives

• Duplex Ultrasound: Non-invasive but may not provide as detailed images.
• CT or MR Angiography: Alternative imaging techniques; CT involves radiation, MR avoids it but may not be suitable for all patients.
• Conservative management: Medications and lifestyle changes, less precise but non-invasive.

Patient Experience

During the procedure, you may feel some pressure or mild discomfort at the insertion site. Sedation, if used, can help you relax. Post-procedure, there might be some bruising and soreness, manageable with mild pain relievers. Regular follow-up and adhering to recovery instructions ensure a smooth healing process.