Name of the Procedure:

Angiography, Pulmonary, by Nonselective Catheter or Venous Injection, Radiological Supervision and Interpretation

Summary

Pulmonary angiography is a medical imaging procedure in which contrast dye is injected nonselectively into the venous system to visualize blood vessels in the lungs. This is done under radiological supervision to diagnose and evaluate conditions affecting the pulmonary arteries.

Purpose

Pulmonary angiography is primarily used to diagnose blood clots in the lungs (pulmonary embolism), detect abnormalities in the pulmonary arteries, or assess other vascular conditions affecting the lungs. The goal is to provide a detailed view of the pulmonary vasculature to guide treatment decisions.

Indications

• Sudden shortness of breath or unexplained chest pain.
• Suspected pulmonary embolism.
• Abnormal results from other imaging tests.
• Evaluation of pulmonary hypertension.
• Pre-surgical planning for lung procedures.

Preparation

• Fasting for several hours before the procedure.
• Adjusting or stopping certain medications as advised by the doctor.
• Pre-procedure blood tests to assess kidney function and clotting ability.
• Signing a consent form after discussing risks and benefits.

Procedure Description

• The patient lies on an examination table.
• An intravenous (IV) line is set up to administer fluids and medications.
• Local anesthesia is applied to the insertion site, usually the groin or arm.
• A catheter is inserted into the vein and guided towards the pulmonary arteries.
• Contrast dye is injected through the catheter.
• Real-time X-ray images are captured to visualize blood flow in the lungs.
• The catheter is then carefully removed, and the insertion site is bandaged.

Duration

The procedure typically takes 30 minutes to 1 hour.

Setting

Pulmonary angiography is performed in a hospital's radiology department or a specialized outpatient clinic equipped with advanced imaging technology.

Personnel

• Interventional radiologist or cardiologist.
• Radiology technologist.
• Nurses and, if needed, an anesthesiologist.

Risks and Complications

• Allergic reaction to the contrast dye.
• Bleeding or bruising at the catheter insertion site.
• Blood clot formation.
• Infection.
• Rarely, damage to blood vessels or kidneys.

Benefits

• Accurate diagnosis of pulmonary embolism and other vascular conditions.
• Allows for targeted treatment planning.
• Minimally invasive with a relatively quick recovery time.

Recovery

• Monitoring in a recovery area for a few hours post-procedure.
• Instructions to keep the insertion site clean and dry.
• Avoid strenuous activities for 24-48 hours.
• Follow-up appointments to discuss results and further treatment.

Alternatives

• CT pulmonary angiography (CTPA): A non-invasive imaging test.
• Ventilation-perfusion (V/Q) scan: Assesses airflow and blood flow in the lungs.
• D-dimer blood test: Identifies the likelihood of blood clots but is less specific.

Patient Experience

During the procedure, patients may feel pressure at the catheter insertion site and a warm sensation when the dye is injected. Post-procedure, there may be mild discomfort at the insertion site, which can be managed with over-the-counter pain relief. Patients are usually able to return home the same day but should follow specific care instructions provided by their healthcare team.