Abstract
Peripheral arterial disease is a debilitating and progressive disorder that affects millions of people worldwide (American College of Cardiology et al. Vasc Med 16(6):452–476, 2011; European Stroke et al. Eur Heart J 32(22):2851–2906, 2011). Advances in noninvasive modalities provide adequate methods for timely and accurate diagnosis. Despite these advancements, diagnostic angiography remains the gold standard for identification of vascular stenosis specifically if intervention is planned (Hirsch et al. J Am Coll Cardiol 47(6):1239–1312, 2006).
As with any invasive procedures, complications occur with catheter-based contrast angiography. There is a 1 % incidence of vascular complications, most of which are local bleeding at the arterial access site (Kern The cardiac catheterization handbook. Elsevier Inc, California, 2011). Less common complications include adverse reactions to contrast media (Shehadi and Toniolo Radiology 137(2):299–302, 1980), contrast-induced nephropathy (Gleeson and Bulugahapitiya 2004), and vascular injury related to catheter manipulation.
This chapter serves as a general introduction to the catheterization laboratory and diagnostic angiography. Imaging methods and standard equipment used in the endovascular suite will be described. The two most commonly used vascular access techniques, methods for selective angiography, and optimal views for arterial and venous angiography will also be discussed.
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- Coronary angiography:
-
Imaging modality that utilizes fluoroscopy and contrast dye that is injected into vessels of the heart to identify areas of stenosis or focal narrowing.
- Diagnostic angiography:
-
Fluoroscopic image acquisition of contrast dye directly injected into vascular systems by means of endovascular catheters, allowing identification and localization of vascular lesions.
- Digital subtraction angiography:
-
Modification of cineangiography in which real-time capture of static surrounding tissues over a span of time is performed prior to contrast injection and then subsequently used to create a mask which will then be used to subtract away these surrounding tissue during delivery of contrast into the vessel. This allows improved resolution and definition of the vascular structure for more accurate diagnosis of lesions.
- Peripheral angiography:
-
Similar in concept to coronary angiography where contrast is injected into arteries of peripheral organ systems to diagnose vascular occlusions and/or narrowing that is causing ischemic symptoms.
- Standard cineangiography:
-
Series of images or image frames that are captured over a short period of time usually utilized to observe the flow of contrast as it fills an artery and continues distally, allowing the observer to localize areas of stenosis or vascular lesions.
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Htyte, N., Jenkins, J.S. (2015). Diagnostic Cerebral and Peripheral Angiography. In: Lanzer, P. (eds) PanVascular Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-37078-6_39
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