Name of the Procedure:

Angiography, Pulmonary, Unilateral, Selective, Radiological Supervision and Interpretation

Summary

Pulmonary angiography is a medical imaging procedure used to visualize the blood vessels in the lungs. It involves the use of a special dye (contrast material) and X-rays to take detailed images of the pulmonary arteries. This procedure is selective and focuses on a specific part of one lung.

Purpose

Pulmonary angiography is performed to diagnose and evaluate conditions affecting the blood vessels in the lungs, such as pulmonary embolism (blood clots), arteriovenous malformations, and other vascular abnormalities. The goal is to obtain detailed images to aid in diagnosis and guide treatment decisions.

Indications

• Suspected pulmonary embolism (blood clots in the lungs)
• Unexplained shortness of breath or chest pain
• Abnormal results from other imaging tests like CT or MRI
• Pulmonary hypertension
• Unusual or abnormal blood vessel structures in the lungs

Preparation

• Patients may be required to fast for several hours before the procedure.
• Certain medications, especially blood thinners, may need to be adjusted or temporarily stopped.
• Blood tests and a thorough medical history are often taken prior to the procedure.
• Patients should inform their doctor of any allergies, especially to iodine or contrast dye.

Procedure Description

1. The patient lies on an X-ray table, and an intravenous (IV) line is inserted into a vein in the arm.
2. Local anesthesia is applied to numb the area where a catheter will be inserted, typically in the groin.
3. Using real-time X-ray guidance (fluoroscopy), the catheter is advanced through the blood vessels to the pulmonary artery.
4. Once in position, contrast dye is injected through the catheter and X-ray images are taken.
5. The images are reviewed in real-time by a radiologist to ensure all necessary views are captured.
6. The catheter is then removed, and pressure is applied to the insertion site to prevent bleeding.

Duration

The procedure typically takes about 30 to 60 minutes, though it may vary depending on the complexity.

Setting

Pulmonary angiography is usually performed in a hospital's radiology or interventional suite, often as an inpatient or outpatient procedure.

Personnel

• Radiologist (specializes in medical imaging)
• Interventional radiologist (performs the catheterization)
• Nurses (assist with preparation and post-procedure care)
• Technologists (operate imaging equipment)

Risks and Complications

• Allergic reaction to contrast dye
• Bleeding or bruising at the catheter insertion site
• Infection
• Damage to blood vessels
• Rarely, complications such as kidney damage or irregular heart rhythms

Benefits

• Accurate diagnosis of pulmonary vascular conditions
• Guided therapy decisions
• Detailed visualization of blood flow in the lungs
• Relief from symptoms by identifying the underlying cause

Recovery

• Patients are typically monitored for several hours after the procedure.
• Instructions may include resting and avoiding strenuous activities for a day or two.
• Keep the insertion site clean and dry; follow any other care guidelines provided.
• Follow-up appointments may be necessary to review results and plan further treatment.

Alternatives

• CT Pulmonary Angiography (CTPA): Non-invasive, involves CT imaging.
• MRI Angiography: An alternative for patients allergic to iodine-based contrast dye.
• V/Q Scan: A nuclear medicine test to evaluate blood flow and air flow in the lungs.
• Ultrasound: Useful in certain cases, but limited for pulmonary vasculature.

Patient Experience

• Patients may feel a warm sensation upon injection of the contrast dye.
• Discomfort at the catheter insertion site is common but usually mild.
• Pain management includes local anesthesia and possibly over-the-counter pain relief post-procedure.
• Overall, the procedure is minimally invasive with a quick recovery time for most patients.