Name of the Procedure:

Angiography, visceral, selective or supraselective (with or without flush aortogram)

Summary

Angiography is a medical imaging technique that uses X-rays to visualize the blood vessels. The visceral angiography specifically focuses on the arteries that supply blood to major organs like the liver, intestines, and kidneys. It involves the selective or supraselective administration of a contrast dye to highlight these vessels and can include a flush aortogram for broader imaging of the arterial system.

Purpose

Visceral angiography is primarily used to diagnose and evaluate conditions affecting the blood vessels of the abdominal organs. It helps identify blockages, aneurysms, tumors, and other vascular abnormalities. The procedure can guide interventional treatments and surgical planning.

Indications

• Unexplained abdominal pain
• Suspected gastrointestinal bleeding
• Liver or renal tumors
• Aneurysms in the abdominal arteries
• Vascular malformations or blockages

Preparation

• Patients are typically required to fast for at least 6-8 hours before the procedure.
• Medication adjustments, especially blood thinners, may be necessary.
• Pre-procedure diagnostics could include blood tests, kidney function tests, and prior imaging studies.

Procedure Description

1. The patient lies on an X-ray table.
2. A local anesthetic is applied to the groin or wrist area where a catheter will be inserted.
3. A catheter is guided through the artery to the targeted visceral arteries.
4. Contrast dye is injected through the catheter.
5. X-ray images are captured as the dye flows through the vessels.
6. In some cases, a flush aortogram is performed for a comprehensive view.
7. After imaging, the catheter is removed, and pressure is applied to prevent bleeding.

Tools/Equipment:

• X-ray machine
• Catheters
• Contrast dye

Anesthesia:

• Local anesthesia at the insertion site, with possible mild sedation.

Duration

The procedure typically takes about 1-2 hours, depending on the complexity.

Setting

Visceral angiography is performed in the radiology department of a hospital or a dedicated imaging center.

Personnel

• Interventional radiologist
• Radiologic technologists
• Nurses
• Anesthesiologist (if sedation is used)

Risks and Complications

• Allergic reaction to contrast dye
• Bleeding or bruising at the catheter insertion site
• Infection
• Blood vessel damage
• Kidney damage from the contrast dye
• Rarely, issues such as stroke or heart attack

Benefits

• Accurate diagnosis of vascular conditions
• Helps in planning further treatments such as surgery or interventional procedures
• Minimally invasive with relatively quick recovery

Recovery

• Patients are typically observed for a few hours for any immediate complications.
• Instructions may include resting for the day and avoiding strenuous activities.
• Follow-up appointments are often scheduled to discuss the results and next steps.

Alternatives

• Non-invasive imaging tests like CT angiography or MR angiography
• Ultrasound, in some cases, for vascular assessments
• Traditional surgery or exploratory procedures for more invasive diagnosis

Patient Experience

During the procedure, patients might feel a slight sting from the anesthetic and pressure at the catheter insertion site. There might also be a warm sensation when the contrast dye is injected. Afterward, mild discomfort at the insertion site can occur but is usually manageable with over-the-counter pain relievers.