Extremity angiography

  • Definition
    • Extremity angiography is a test used to see the arteries in the hands, arms, feet, or legs. It is also called peripheral angiography.

      Angiography uses x-rays and a special dye to see inside the arteries. Arteries are blood vessels that carry blood away from the heart.

  • Alternative Names
    • Angiography of the extremity; Peripheral angiography; Lower extremity angiogram; Peripheral angiogram; Arteriography of the extremity

  • How the Test is Performed
    • This test is done in a hospital. You will lie on an x-ray table. You may ask for some medicine to make you sleep and relax (sedative) if you are anxious about the test.

      • The health care provider will shave and clean an area, most often in the groin.
      • A numbing medicine (anesthetic) is injected into the skin over an artery.
      • A needle is placed into that artery.
      • A thin plastic tube called a catheter is passed through the needle into the artery. The doctor moves it into the area of the body being studied. The doctor can see live images of the area on a TV-like monitor, and uses them as a guide.
      • Dye flows through the catheter and into the arteries.
      • X-ray images are taken of the arteries.

      Certain treatments can be done during this procedure. These treatments include:

      • Dissolving a blood clot with medicine
      • Opening a partially blocked artery with a balloon
      • Placing a small tube called a stent into an artery to help hold it open

      The health care team will check your pulse (heart rate), blood pressure, and breathing during the procedure.

      The catheter is removed when the test is done. Pressure is placed on the area for 10 to 15 minutes to stop any bleeding. A bandage is then put on the wound.

      The arm or leg where the needle was placed should be kept straight for 6 hours after the procedure. You should avoid strenuous activity, such as heavy lifting, for 24 to 48 hours.

  • How to Prepare for the Test
    • You should not eat or drink anything for 6 to 8 hours before the test.

      You may be told to stop taking certain medicines, such as aspirin or other blood thinners for a short while before the test. Never stop taking any medicines unless told to do so by your provider.

      Make sure your provider knows about all the medicines you take, including those you bought without a prescription. This includes herbs and supplements.

      Tell your provider if you:

      • Are pregnant
      • Are allergic to any medications
      • Have ever had an allergic reaction to x-ray contrast material or iodine substances
      • Have ever had any bleeding problems
  • How the Test will Feel
    • The x-ray table is hard and cold. You may want to ask for a blanket or pillow. You may feel some stinging when the numbing medicine is injected. You may also feel some pressure as the catheter is moved.

      The dye can cause a feeling of warmth and flushing. This is normal and most often goes away in a few seconds.

      You may have tenderness and bruising at the site of the catheter insertion after the test. Seek immediate medical help if you have:

      • Swelling
      • Bleeding that doesn't go away
      • Severe pain in an arm or leg
  • Why the Test is Performed
    • You may need this test if you have symptoms of a narrowed or blocked blood vessel in the arms, hands, legs, or feet.

      The test may also be done to diagnose:

      • Bleeding
      • Swelling or inflammation of the blood vessels (vasculitis)
  • Normal Results
    • The x-ray shows normal structures for your age.

  • What Abnormal Results Mean
    • An abnormal result is commonly due to narrowing and hardening of the arteries in the arms or legs from plaque buildup (hardening of the arteries) in the artery walls.

      The x-ray may show a blockage in the vessels caused by:

      • Aneurysms (abnormal widening or ballooning of part of an artery)
      • Blood clots
      • Other diseases of the arteries

      Abnormal results may also be due to:

  • Risks
    • Complications may include:

      • Allergic reaction to the contrast dye
      • Blood clot that travels to the lungs
      • Damage to the blood vessel as the needle and catheter are inserted
      • Excessive bleeding or a blood clot where the catheter is inserted, which can reduce blood flow to the leg
      • Heart attack or stroke
      • Hematoma, a collection of blood at the site of the needle puncture
      • Injury to the nerves at the needle puncture site
      • Kidney damage from the dye

      There is low-level radiation exposure. However, most experts feel that the risk of most x-rays is smaller than other risks we take every day. Pregnant women and children are more sensitive to the risks of the x-ray.

  • References
    • Jackson JE, Meaney JFM. Angiography. In: Adam A, Dixon AK, Gillard JH, Schaefer-Prokop CM, eds. Grainger & Allison's Diagnostic Radiology: A Textbook of Medical Imaging. 6th ed. New York, NY: Elsevier Churchill Livingstone; 2014:chap 84.