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Peripheral Angiography

Peripheral angiography is a type of test that uses contrast dye and x-rays to help the doctor in finding blocked areas or narrow areas in one or more arteries supplying blood to the feet, legs, hands, or arms. 

A peripheral angiography helps the doctor if a surgical procedure is required for opening a blocked artery. An artery is a blood vessel that carries blood away from the heart. The test is also known as extremity angiography.

 

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Causes: An abnormal result in a peripheral angioplasty can occur due to the following reasons:

  • Narrowing and hardening of the arteries in the legs or arms due to the buildup of plaque in the walls of the arteries
  • Blood clot formation
  • Other diseases of the arteries
  • Aneurysms (abnormal ballooning or widening of a part of the artery)
  • Injury to the blood vessels
  • Inflammation of the blood vessels
  • Buerger disease (a rare disease caused by a small blood vessel getting swollen and inflamed)
  • Takayasu disease (inflammation of large arteries like the aorta, which is the main artery of the heart carrying blood from the heart to the rest of the body)

Symptoms: The following symptoms may indicate the need for a peripheral angiography:

  • Weakness in the legs
  • Numbness in the legs
  • Sores or ulcers, which may take a long time to heal
  • Gangrene
  • Erectile dysfunction in men
  • Loss of hair on the legs
  • Slow growth of toenails
  • Brittle toenails
  • Skin on the affected area is pale and bluish, or shiny in appearance

A peripheral angiography can be done in association with other diagnostic tests like:

  1. Ankle-brachial index pressure: This is a quick, non-invasive method to check for the presence of peripheral artery disease.
  2. Magnetic resonance angiography: A powerful magnetic field, radio waves, and a computer is used to evaluate the blood vessels and identify the abnormalities.
  3. CT angiography: A contrast material is injected into the blood vessels and a CT scan is performed to help in diagnosing and evaluating any blood vessel diseases.
  4. Doppler and ultrasound imaging: It is an imaging test that uses sound waves to estimate the blood flow through the blood vessels.

 

  • You will lie on the x-ray table.
  • You may be given a sedative before the procedure, to help you relax.
  • The area of the procedure, which is most often the groin region, is shaved and cleaned.
  • A local anesthesia (a numbing agent) is injected into the skin over an artery.
  • A needle is placed in the above artery.
  • A thin, plastic tube, known as a catheter, is passed through the needle into the artery.
  • The catheter is guided into the area of the body that is being studied. The doctor can view the live images of the area on a monitor, and use them as a guide.
  • A dye is injected through the catheter into the arteries.
  • X-ray images of the arteries are taken.
  • The dye makes the blocked or narrow portion of the arteries appear clearly on the x-rays.
  • It is normal to feel hot or flushed for a few seconds after dye insertion.
  • Some treatments can also be performed during the procedure such as:
  • Injecting a medicine to dissolve the blood clot.
  • Opening a blocked artery using a balloon.
  • Placement of a small tube, known as a stent, into the artery to help it stay open.
  • The catheter is removed once the procedure is completed.

 

The complications of peripheral angiography may include:

  • Blood vessel damage at the site of needle and catheter insertion

  • Injury to the blood vessels that are being tested

  • Nerve injury at the needle puncture site

  • Blood clot formation or excessive bleeding at the site of catheter insertion, causing reduced blood flow to the leg

  • Allergic reaction to the contrast dye used

  • Heart attack

  • Stroke (interrupted blood flow to the brain)

  • Hematoma (blood collection at the site of needle puncture)

  • Damage to the kidneys 

  • Loss of limb

  • Pressure is applied on the puncture site for approximately 10 to 20 minutes after the procedure.

  • A bandage is then applied to the wound.

  • You will be asked to keep the leg that is being used for the catheter straight for at least six hours after the procedure.

  • It is normal to have a small bruise at the site of the puncture.

  • You will be closely monitored for any bleeding or swelling after the procedure.

  • Drink lots of fluids once you go home.

  • Avoid heavy lifting or other strenuous activities for 2 days after the procedure.

  • Normally, you will be able to start with solid food and take your regular medications four to six hours after the angiogram.

  • Avoid driving for at least two days after the procedure.

  • The site of puncture may feel tender for a couple of days after the procedure.

  • You can usually resume your daily activities the next day after the procedure.

  • You can gradually resume your normal activities, allowing the incision to heal.

  • If you notice any bleeding from the site of the puncture, lie flat and then press firmly on the bleeding spot.

  • Contact your doctor immediately if you notice any of the following:

  • The leg with the puncture tingles or becomes numb

  • The foot turns blue or feels cold

  • The puncture site swells up

  • Fluid drainage from the puncture site

  • Bleeding from the site of puncture does not slow down even after firmly pressing on it

Peripheral Angiography from one of the best multi-speciality hospital: Manipal Hospital Malleshwaram, Malleshwaram, Bengaluru

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