Pulmonary angiography is a procedure that uses a special dye (contrast dye) and x-rays to see how blood flows through the lungs.
An angiography is an imaging test that uses x-rays and a special dye to see the inside of the arteries. Arteries are the blood vessels that carry blood from the heart .
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- 1 How the test is performed
- 2 Preparation for the exam
- 3 How the test will feel
- 4 Reasons why the exam is performed
- 5 Normal Values
- 6 Meaning of abnormal results
- 7 What are the risks
- 8 Alternative names
- 9 Source
How the test is performed
The examination is performed in a special unit in the hospital. You are asked to lie on a table where the x-rays are taken .
- Before the exam begins, a mild sedative is applied to help relax the patient.
- An area of your body, usually your arm or groin, is cleaned and numbed with a local anesthetic.
- The radiologistinserts a needle or makes a small incision in a vein in the area that has been cleaned and inserts a thin, hollow tube called a catheter.
- The catheter is placed through the vein and carefully brought up to and through the right chambers of the heart and into the pulmonary artery, which goes to the lungs. The doctor can view live x-ray images of the area on a television monitor and use them as a guide.
- Once the catheter is in place, the dye (contrast material) is injected into the catheter. X-rays are taken to see how the dye moves through the pulmonary arteries. The dye helps highlight any blockages in blood flow.
Pulse, blood pressure, and respiration are monitored during the procedure. Electrocardiogram (ECG) leads are taped to the arms and legs to monitor the electrical impulses of the heart .
After the x-rays are taken, the needle and catheter are removed. Pressure is immediately applied to the puncture site for 20 to 45 minutes to stop the bleeding. After that time, the area is checked and a tight bandage is applied. The leg should be kept straight for 6 hours after the procedure.
Rarely, this technique can be used to administer medications to the lungs when a blood clot has been found.
Preparation for the exam
The patient should not eat or drink anything for 6 to 8 hours before the exam. You are required to wear a hospital gown and to sign an authorization for the procedure. Remove jewelry from the area to be examined.
The patient should comment to the doctor:
- If you are pregnant.
- If you have ever had an allergic reaction to x-raycontrast material or iodine.
- If you are allergic to any medicine.
- What medications are you taking (including any herbal preparations).
- If you have ever had a bleeding problem.
How the test will feel
The X-ray table is hard and cold, but the patient may ask to borrow a blanket or pillow. A brief sting may be felt when anesthesia is applied and a sharp, brief prick may be felt as the catheter is inserted.
Some pressure can be felt as the catheter goes up to the lungs. Contrast medium can cause a feeling of heat and suffocation. This is normal and usually goes away after a few seconds. Some tenderness and bruising may occur at the injection site after the exam.
Reasons why the exam is performed
The test is used to detect blood clots ( pulmonary embolism ) and other blockages in the blood flow to the lungs. Most of the time, the doctor will have already tried other tests to diagnose a blood clot in the lungs.
Pulmonary angiography can also be used to help the doctor diagnose:
- Arteriovenous malformations of the lung.
- Congenital narrowing (present from birth) of the pulmonary vessels.
- Aneurysms of the pulmonary arteries.
- Pulmonary hypertension: high blood pressure in the arteries of the lungs.
The radiograph shows normal structures according to the age of the patient.
Meaning of abnormal results
Abnormal results may be due to:
- Aneurysms of the pulmonary vessels.
- Blood clot in the lungs ( pulmonary embolism).
- Narrow blood vessel.
- Primary pulmonary hypertension.
- Tumor in the lung.
What are the risks
During the procedure, an abnormal heart rhythm may occasionally occur that doctors can monitor and treat. Other risks include:
- Allergic reaction to contrast medium.
- Damage to the blood vessel as the needle and catheter are inserted.
- Blood clot that travels to the lungand causes an embolism .
- Excessive bleeding or a blood clot where the catheter is inserted, which can reduce circulation to the leg.
- Heart attackor stroke .
- Hematoma (a collection of blood at the site of the needle piercing).
- Nerve injury at the puncture site.
- Kidney damage from the contrast medium.
Exposure to radiation is low. The X rays are controlled and regulated to provide the minimum amount of radiation exposure needed to produce an image. Most experts think that the risk is low compared to the benefits. Pregnant women and children are most sensitive to the risks of exposure to x-rays.
Pulmonary arteriography; Pulmonary angiogram; Angiography of the lungs