Angiogram
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225965349
2008-07-16T06:22:21Z
122.111.39.196
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[[Image:Angiogram WHO 933.jpg|thumb|right|250px|Patient about to undergo an angiogram, image courtesy of WHO.]]
'''Angiography'' or ''arteriography''' is a [[medical imaging]] technique in which an [[X-ray]] image is taken to visualize the inside or ([[lumen (anatomy)|lumen]]) of blood vessles and organs of the body. With particular interest in the [[artery|arteries]], [[vein]]s and the [[heart chamber]]s.
Its name comes from the [[Greek language|Greek]] words ''angeion'', "vessel", and ''graphein'', "to write or record". The X-ray film or image of the [[blood vessel]]s is called an '''angiograph''', or more commonly, an '''angiogram'''.
The [[Portugal|Portuguese]] physician and neurologist [[Egas Moniz]], [[Nobel Prize]] winner in [[1949]], developed in [[1927]] the technique of contrasted x-ray [[cerebral angiography]] to diagnose several kinds of nervous diseases, such as tumors and [[arteriovenous malformations]]. He is usually recognised as one of the pioneers in this field. With the introduction of the [[Seldinger technique]] in [[1953]], the procedure became markedly safer as no sharp introductory devices needed to remain inside the vascular lumen.
==Technique==
Depending on the type of angiogram, access to the blood vessels is gained most commonly through the [[Femoral artery]], to look at the left side of the heart and the arterial system or the [[Jugular]] or [[Femoral vein]], to look at the right side of the heart and the venous system. Using a system of [[Guide wire]]s and [[Catheters]], a type of [[Contrast agent]] (which shows up by absorbing the x-rays), is added to the blood to make it visible on the x-ray images.
The [[X-ray]] images taken may either be still images, displayed on a [[Image intensifier]] or film, or motion images. For all structures except the heart, the images are usually taken using a technique called [[Digital subtraction angiography (DSA)]]. Images in this case are usually taken at 2 - 3 frames per second, which allows the [[radiologist]] to evaluate the flow of the blood through a vessel or vessels. This technique "subtracts" the bones and other organs so only the vessels filled with contrast agent can be seen. The heart images are taken at 15-30 frames per second, not using a subtraction technique. Because DSA requires the patient to remain motionless, it cannot be used on the heart. Both these techniques enable the radiologist or cardiologist to see [[stenosis]] (blockages or narrowings) inside the vessel which maybe inhibiting the flow of blood and causing pain.
==Uses==
===Coronary Angiography===
{{main|Cardiac catheterization}}
One of most common angiograms performed is to visualize the blood in the [[coronary artery|coronary arteries]]. A long, thin, flexible tube called a [[catheter]] is used to administer the x-ray contrast agent at the desired area to be visualized. The catheter is threaded into an artery in the [[groin]] or [[forearm]], and the tip is advanced through the arterial system into one of the two major coronary arteries. [[X-ray]] images of the transient [[radiocontrast]] distribution within the blood flowing within the coronary arteries allows visualization of the size of the artery [[lumen|openings]]. Presence or absence of [[atherosclerosis]] or [[atheroma]] within the walls of the [[artery|arteries]] cannot be clearly determined. See [[coronary catheterization]] for more detail.
===Peripheral Angiography===
{{main|Peripheral artery occlusive disease}}
Angiography is also commonly performed to identify vessel [[stenosis|narrowing]] in patients with leg claudication or ''cramps'', caused by reduced blood flow down the legs and to the feet; in patients with renal stenosis (which commonly causes high blood pressure) and can be used in the head to find and repair stroke. These are all done routinely through the femoral artery, but can also be performed through the brachial or axillary (arm) artery. Any stenoses found may be treated by the use of [[Angioplasty]].
===Other===
Other angiographic uses include the diagnosis of [[retina]]l vascular disorders, such as [[diabetic retinopathy]] and [[macular degeneration]].
==Historic usage==
The term '''angiography''', or '''angeiography''', was originally used of a description of the [[weight]]s, [[Units of measurement|measures]], vessels, etc, used by several nations.
==The Future==
Due to the advancement in medical imaging, it is now possible to perform almost all Angiograms through a [[CT scanner]], known as [[Computed tomography angiography]]. This is better for the patient as it is less invasive with fewer associated risks.
==See also==
*[[Intravenous digital subtraction angiography]]
*[[Angiography]]
*[[Contrast Medium]]
*[[Image intensifier]]
*[[Computed Tomography Angiography]]
*[[Cardiac catheterization]]
*[[Peripheral artery occlusive disease]]
==External links==
* [http://www.mdct.com.au MDCT] - The radiology information resource for Cardiologists, Radiologists, Cardiac and Radiologic Techs - A Free Resource For Cardiac Imaging
* [http://radiologyinfo.org/en/sitemap/modal-alias.cfm?modal=Angio RadiologyInfo] - The radiology information resource for patients: Angiography procedures
* [http://www.ptca.org/imaging/cath.html Cardiac Catheterization] from Angioplasty.Org
* [http://www.medical.siemens.com/webapp/wcs/stores/servlet/CategoryDisplay?categoryId=12751&langId=-1&catalogId=-1&storeId=10001&catTree=100001,12764,12751&overviewId=12751&userviewId=12813&parentName=Angiography&level=0 Angiography Equipment] from Siemens Medical
* [http://www.cirse.org/index.php?pid=85 Cardiovascular and Interventional Radiological Society of Europe]
* [http://www.emdmedical.com/ Worldwide Angiography Manufacturer ]
[[Category:Cardiovascular system]]
[[Category:Cardiology]]
[[Category:Radiology]]
[[Category:Surgery]]
[[Category:Medical imaging]]
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