BEE ENN COLLEGE OF NURSING

ASSIGNMENT ON

ANGIOGRAPHY

Submitted to Submitted by
Smt. Kusum Lata Ms. Tania
Academic coordinator M.Sc(N) 1styear
BECON BECON

Submitted on - -05-24
INTRODUCTION TO ANGIOGRAPHY:
Angiography is a crucial medical imaging technique used to visualize blood vessels in the
body. Through this method, physicians can obtain detailed images of the vascular system,
aiding in the diagnosis and treatment of various cardiovascular conditions. Angiography has
revolutionized the field of medicine by providing clinicians with a non-invasive means to
assess vascular health and detect abnormalities.

DEFINITION
Angiography is a medical imaging technique used to visualize the blood vessels in the body.
It involves the introduction of a contrast agent into the bloodstream, which enhances the
visibility of blood vessels on imaging studies such as X-rays, computed tomography (CT),
magnetic resonance imaging (MRI), or fluoroscopy. Angiography plays a crucial role in
diagnosing and treating various vascular conditions, including coronary artery disease,
peripheral artery disease, cerebrovascular diseases, and vascular abnormalities. By providing
detailed images of the vascular anatomy, angiography helps physicians to identify blockages,
narrowing, aneurysms, or other abnormalities in the blood vessels, guiding treatment
decisions and interventions.

PRINCIPLE OF ANGIOGRAPHY:
At its core, angiography relies on the principle of introducing a contrast agent into the
bloodstream to enhance the visibility of blood vessels during imaging. Typically, this contrast
agent contains iodine, which is highly radiopaque and absorbs X-rays, making blood vessels
more visible on X-ray images. Various imaging modalities, such as X-ray fluoroscopy,
computed tomography (CT), and magnetic resonance imaging (MRI), can be used to capture
images of the contrast-filled vessels, providing detailed anatomical information.

TYPES OF ANGIOGRAPHY:
Catheter Angiography:
Also known as conventional angiography, this method involves inserting a catheter into a
specific artery or vein, typically in the groin or arm, and injecting contrast dye directly into
the target vessel. X-ray fluoroscopy then captures real-time images of the contrast as it flows
through the blood vessels.

CT Angiography (CTA):
In CTA, a CT scanner is used to acquire detailed cross-sectional images of the blood vessels
after intravenously injecting a contrast agent. This technique offers high-resolution images
and is particularly useful for evaluating vascular diseases affecting the brain, heart, and
peripheral arteries.

Magnetic Resonance Angiography (MRA):

MRA utilizes magnetic resonance imaging technology to create detailed images of blood
vessels without the use of ionizing radiation. By manipulating the magnetic properties of
hydrogen atoms in the body, MRA produces high-quality images of blood flow in both
arteries and veins.

Digital Subtraction Angiography (DSA):

DSA is a specialized form of angiography that subtracts a pre-contrast image from
subsequent contrast-enhanced images, highlighting only the blood vessels and reducing
background noise. This technique provides clear visualization of small blood vessels and is
commonly used in neurovascular and interventional procedures.

INDICATIONS FOR ANGIOGRAPHY:

Angiography is indicated for a wide range of medical conditions related to the cardiovascular
system, including:

Evaluation of Coronary Artery Disease (CAD): Angiography is the gold standard for
diagnosing CAD by assessing the degree of stenosis or blockage in the coronary arteries.
Diagnosis of Peripheral Artery Disease (PAD): Angiography helps identify narrowed or
occluded arteries in the legs, arms, or other peripheral areas.
Assessment of Cerebrovascular Diseases: Angiography aids in diagnosing stroke,
intracranial aneurysms, and other cerebrovascular abnormalities by visualizing the blood
vessels in the brain.
Detection of Renal Artery Stenosis: Angiography is used to assess the blood flow to the
kidneys and detect any narrowing or blockages in the renal arteries.
Evaluation of Vascular Abnormalities: Angiography can identify vascular malformations,
aneurysms, and arteriovenous fistulas in various parts of the body.

PROCEDURE OF ANGIOGRAPHY:
The procedure for angiography involves several key steps:
 1. Patient Preparation: Patients may need to fast for a few hours before the procedure,
and medications such as anticoagulants may need to be adjusted. Consent forms are
obtained, and patients are briefed on the procedure and potential risks.
2. Contrast Injection: A contrast agent is injected into the bloodstream, either through a
catheter inserted into a peripheral vein (for CT and MRI angiography) or directly into
an artery (for catheter angiography). The contrast flows through the blood vessels,
highlighting their contours on imaging.
3. Imaging Acquisition: Depending on the type of angiography, imaging is performed
using X-ray fluoroscopy, CT scanning, MRI, or a combination of these modalities.
Specialized equipment captures detailed images of the contrast-filled vessels in real-
time or as cross-sectional slices.
4. Post-Procedure Care: After the imaging is complete, patients are monitored for any
immediate complications, such as allergic reactions to the contrast agent or bleeding
at the catheter insertion site. They may be observed for a short period before being
discharged, with instructions for follow-up care as needed.

ADVANTAGES AND LIMITATIONS:

Advantages:
High-resolution imaging of blood vessels, allowing for accurate diagnosis and treatment
planning.
Real-time visualization of blood flow during catheter angiography, aiding in the assessment
of vascular function.
Versatility in imaging various vascular territories throughout the body.
Ability to guide minimally invasive interventions, such as angioplasty, stenting, and
embolization.

Limitations:
Invasiveness of some procedures, which may carry risks such as bleeding, infection, or
allergic reactions to contrast agents.
Exposure to ionizing radiation during X-ray-based angiography, particularly in catheter
angiography and CT angiography.
Potential renal toxicity associated with iodinated contrast agents, especially in patients with
pre-existing kidney disease.
Safety Considerations:
Safety measures are essential during angiography procedures to minimize risks to patients
and healthcare providers:
Patient screening for allergies, kidney function, and other contraindications to contrast agents.
Monitoring patients for adverse reactions during and after contrast injection, with appropriate
management protocols in place.
Minimizing radiation exposure by using the lowest effective dose for imaging and employing
radiation shielding whenever possible.
Strict aseptic techniques to reduce the risk of catheter-related infections and other procedural
complications.

Recent Advances:
Recent advancements in angiography technology have focused on improving image quality,
reducing radiation dose, and enhancing procedural efficiency:

➢ Development of low-dose imaging protocols and iterative reconstruction algorithms

to reduce radiation exposure in CT angiography.
➢ Integration of 3D imaging capabilities into angiography systems, allowing for better
visualization of complex vascular anatomy.
➢ Introduction of novel contrast agents with improved safety profiles and reduced risk
of adverse reactions.
➢ Adoption of robotic-assisted techniques for catheter manipulation during
interventional procedures, enhancing precision and operator ergonomics.
 ROLE OF NURSE

• Preparation: Explain the procedure, obtain consent, ensure patient compliance

with instructions.

• Assessment and Monitoring: Assess vital signs, monitor throughout the

procedure.

• Assistance: Help with positioning, equipment preparation, catheter insertion.

• Medication/Contrast: Administer drugs, contrast agents as prescribed.
• Education/Support: Provide information, emotional support to patient and
family.

• Post-Procedure Care: Monitor for complications, provide wound care, give

instructions.

• Documentation/Communication: Document accurately, communicate

effectively with the team.
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