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© Dirk Biddle
An angiogram (arteriogram) is a procedure used to examine almost any artery (including those of the head, kidneys, heart and lungs) where contrast medium (x-ray dye) is injected into the arteries in question via catheter (a long, narrow, flexible tube, usually inserted through the femoral artery in the groin – as this artery is the easiest large artery to access - and guided to the site of examination) and x-ray images (via a fluoroscope) of the vessels are analysed to determine the extent of any vessel damage. An angiogram is sometimes used as part of a procedure to repair the blood vessels (eg; balloon angioplasty).
A renal angiogram is commonly utilised in cases of suspected polyarteritis nodosa to observe evidence of inflammatory damage to the renal arteries (such as the presence of aneurysms, narrowing of the artery, blood clots, or bleeding in the kidney). For those with contrast allergies, or other contraindications to contrast use, Magnetic Resonance Angiography (MRA) can be performed (see MRI below). This procedure is non-invasive and can provide similar imaging of the renal vessels.
On angiography, vasculitis is characterised by “beading” (dilated areas alternating with narrowing of the blood vessels). A strikingly abnormal angiogram may eliminate the need for a kidney, lung or brain biopsy.
A lung angiogram may be utilised in cases of suspected Wegener’s Granulomatosis and a Central Nervous System angiogram is frequently part of the “work-up” of CNS vasculitis. These procedures are identical to an abdominal or renal angiogram, except the catheter is advanced all the way up to the large vessels supplying the lung or the head and neck (eg; the carotid arteries).
You may feel some discomfort at the site where the IV catheter is placed, although local anaesthetic will be used. Most blood vessels do not have nerve endings, so you probably won't feel the catheter inside of your body – although some patients do (including the author of this article!). After the X-rays are taken, the catheter is withdrawn. Pressure is immediately applied to the groin at the site of insertion for 10 to 15 minutes or more to stop bleeding. After that time, the area is checked and a tight bandage is applied. The leg should be kept straight and immobile for an additional 12 hours after the procedure.
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