Name of the Procedure:

Angiography, adrenal, bilateral, selective, radiological supervision and interpretation

Summary

Angiography of the adrenal glands is an imaging procedure that uses X-ray technology to visualize blood flow in the adrenal arteries. It's performed bilaterally, meaning both the left and right adrenal glands are examined. The procedure involves injecting a contrast dye into the arteries to make the vessels visible on X-ray images.

Purpose

This procedure helps diagnose and evaluate various conditions affecting the adrenal glands, such as tumors, vascular malformations, and adrenal hyperplasia. The main goal is to obtain detailed images of the blood supply to the adrenal glands to aid in diagnosis and guide treatment decisions.

Indications

• Unexplained hypertension (high blood pressure)
• Suspected adrenal tumors or masses
• Adrenal gland hyperactivity or dysfunction
• Follow-up on previous abnormal imaging findings
• Assessment prior to surgical intervention

Preparation

• Patients may need to fast for several hours before the procedure.
• Blood tests may be required to check kidney function and coagulation.
• Certain medications, especially blood thinners, may need to be adjusted or stopped.
• Patients should inform their doctor about any allergies, especially to contrast dye.

Procedure Description

1. The patient lies on an X-ray table.
2. Local anesthesia is administered at the site of catheter insertion, usually in the groin area.
3. A thin catheter is inserted into the femoral artery and guided to the adrenal arteries.
4. Contrast dye is injected through the catheter, and X-ray images are taken.
5. Both adrenal glands are imaged separately.
6. The catheter is removed, and pressure is applied to the insertion site to prevent bleeding.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

The procedure is usually performed in a hospital or specialized radiology center equipped with angiography facilities.

Personnel

• Interventional radiologist
• Radiologic technologists
• Nurses
• Possibly an anesthesiologist, if sedation is required

Risks and Complications

• Allergic reaction to contrast dye
• Bleeding or bruising at the catheter insertion site
• Infection
• Kidney damage from the contrast dye
• Rarely, damage to blood vessels or adrenal glands

Benefits

• Provides detailed images of the adrenal arteries, aiding accurate diagnosis.
• Helps in planning appropriate treatment strategies.
• Minimally invasive with relatively quick recovery.

Recovery

• Patients may need to lie flat for a few hours post-procedure to prevent bleeding.
• The insertion site should be kept clean and dry.
• Most patients can return to normal activities within a day or two.
• Follow-up appointments may be necessary to review results and plan further treatment.

Alternatives

• Computed Tomography (CT) angiography: Non-invasive but may not provide as detailed images.
• Magnetic Resonance Imaging (MRI): No radiation exposure but might not be as effective for all patients.
• Standard ultrasound: Limited in visualizing adrenal blood flow.

Patient Experience

• You will be awake but may feel some pressure or discomfort at the catheter insertion site.
• Contrast dye injection might cause a warm, flushing sensation.
• Mild discomfort post-procedure, managed with over-the-counter painkillers.
• Detailed instructions will be provided to ensure a smooth recovery.