Aortic Angiography

An Aortic Angiogram is an x-ray exam that allows your doctor to look at the aorta and decide if any treatment is necessary. The aorta is the largest blood vessel in your body, starting at your heart and leading down into your abdomen. Problems with the aorta include:

• Cholesterol deposits that can narrow the interior of the aorta,

• Aneurysms which thin the aortic wall, or

• Abnormal tangles of blood vessels.

Either of these conditions could cause bleeding or death. The test is done on an out-patient basis while you are sedated. Dye is injected into an artery in the groin area, and as the dye circulates through the arteries, x-rays are taken. This procedure is very safe and complications are very rare.

Introduction

Sometimes people have serious problems with the biggest blood vessel in the body, the aorta.

An angiogram is a test that helps doctors look at the aorta to decide what kinds of treatment may be needed.

If your doctor recommends an aortic angiogram, the decision whether or not to have this procedure is also yours.

This patient education module will help you understand better the benefits and risks of this procedure.

Anatomy

The aorta is the biggest blood vessel in the body.

It starts at the heart, curves in the chest, and goes down into the abdomen, where it divides into two other arteries.

Along its course, blood vessels branch out of it to take blood to the arms, neck, brain, intestines, kidneys, and legs.

Symptoms And Their Causes

Cholesterol deposits that accumulate in the aorta or its branches can cause the aorta to narrow.

A narrow aorta does not let enough blood to go through the blockage. This causes blood flow to decrease.

This decrease in blood flow could cause severe arm pain and possibly weakness if it occurs in arteries that go to the arms.

It could also cause the same symptoms if it occurs in the arteries that go to the legs.

When the blood vessels going to the kidneys are involved, kidney problems and high blood pressure can result.

Blood vessel abnormalities called ‘aneurysms’ can form.

This ballooning of the blood vessels causes their walls to be thinner than usual. This condition can cause bleeding that could lead to death.

There are other abnormalities in the blood vessels called ‘arteriovenous malformations,’ also known as AVMs. These are abnormal tangles of blood vessels that could also bleed and cause death.

An angiogram helps show the aorta and the blood vessels that take off from it and helps detect any of these abnormalities.

Procedure

An aortic angiogram is usually done on an outpatient basis. This means you can go home after the test is completed.

This procedure is done while you are awake. There is virtually no pain involved.

You are asked to lie down on the x-ray table.

During the procedure, your heart rate, blood pressure and vital signs are continuously monitored.

The groin area is then disinfected and made numb with a local anesthetic.

A long tube called a catheter is then inserted through the skin into an artery in the leg and threaded all the way up into the aorta.

Sometimes, depending on the doctor’s preference and the state of your arteries, the catheter may be inserted in a big artery in the underarm or the upper arm instead of the groin.

Dye is then injected into the arteries and x-rays are taken. The dye makes the arteries visible to the x-ray machine.

When the dye is injected, you may feel some warmth in the face or other parts of the body.

You should stay very still during the x-rays to allow good, sharp pictures to be taken.

After the x-rays, the catheter is taken out and pressure is applied where it went into the skin to ensure that there is no bleeding at that site.

If your physician uses a closure device, you will lie flat for about 1 hour; if not, you will lie flat for up to 8 hours. You should not bend the leg on the side of the groin that was catheterized.

You will probably not be able to drive after the procedure and will need somebody to drive you back home.

Risks And Complications

This procedure is very safe. There are however several possible risks and complications. These are very unlikely but possible. You need to know about them just in case they happen. By being informed you may be able to help your doctor detect complications early.

X-rays are used during this procedure. The amount of radiation during this test is deemed safe. However, this same amount could be dangerous to unborn children. It is therefore very important to make sure you are not pregnant prior to an elective radiological test.

Infection at the injection site is rare.

The catheter placed in the artery can rarely injure the blood vessels of the body. This may cause decreased blood to the leg or arm involved, which may require an operation to reestablish blood flow.

The insertion can also cause injury to a nerve in the leg or arm, depending on where the insertion was done.

Strokes, resulting in permanent paralysis, speech problems, and possibly death, are very rare after an aortic angiogram.

Some people have allergies to the iodine dye used in this test. Make sure to tell your doctor about your allergies and about any possible reactions to any sort of dye used on you in the past.

In some people, dye can cause kidney failure. If you have a kidney problem, you might be at somewhat higher risk.

After The Aortic Angiogram

Make sure to contact your doctor in case of any new symptoms, such as redness, fever, or numbness, weakness, swelling, or bleeding at the puncture site.

Also call your doctor if you have angina, or chest pain.

Your doctor will tell you how soon you can go back to work. This depends on your medical condition. Usually, you should be able to return to work about a week after the procedure.

Summary

The aorta is the largest artery in your body. Other arteries branch off from it to supply blood to nearly the entire body.

However, the aorta can be affected by several kinds of diseases, such as cholesterol deposits, which clog it and slow down blood flow, aneurysms, which balloon out and cause its walls to be thin, and AVM, which are tangles of blood vessels.

The aortic angiogram is a test that helps your doctors look at the aorta so that problems, if any, can be located and treated.

Aortic angiograms are very safe. Risks and complications are very rare. Knowing about them will help you detect them early, if they happen.