Angiography

Angiography is an x-ray examination of the arteries and veins to diagnose obstructions and other blood vessel diseases. The test is performed in a room called an angiography suite as pictured here.The test is performed by a radiologist, cardiologist, or vascular surgeon. During the test, the doctor inserts a small tube known as a catheter through a nick in the skin into an artery or vein. Using guidance from an x-ray flouroscopy machine, the tube is directed into the part of the body that requires study. The catheters come in various sizes and configurations to best access the arteries in question.One such catheter is visualized at right and its tip is coiled. This is referred to as a pigtail catheter for obvious reasons. After the catheter has been threaded into the appropriate position, a substance called contrast agent (also known as x-ray dye) is injected through the catheter while x-ray pictures are made. These can be individual pictures or even a movie of the injection. Below are two representative pictures made during angiography. The one on the left is called aortography with bilateral runoff. This means that dye is injected into the aorta. This dye show up as white against a black background. The dye is allowed to "runoff" or flow downstream into the arterial tree of both legs. The right picture demonstrates carotid angiography in which contrat agent is injected into a carotid artery going to the brain while pictures are taken. Note that in this case the x-ray dye show up as black against a whitish background. The pictures can be manipulated by computer to show up as black on white and vice versa.