 |
 |
| |
||||
|
||||
A B C D E F G H I J K L M N O P R S T U V W |
||||
AORTOGRAPHY / LOWER LIMB ANGIOGRAPHYWhy is an Aortography performed ?This examination is usually carried out because the arteries supplying blood to the legs are believed to be narrowed or blocked. This is usually caused by furring up. The process by which this happens is called hardening of the arteries, or arteriosclerosis. Your doctor will have usually asked for this type of x-ray to be done, so that he can see whether an operation can be performed to allow the blood to get through. Sometimes arteries have been damaged in an accident or become part of a tumour, and the x-ray will give you and the doctor more information about what is happening to the tissues. Preparations needed for an AortographyThe test is always carried out in hospital and usually requires 1 2 days as an inpatient. A few younger patients can be tested as day cases . You will probably be advised to be off work for a week afterwards. You will be safe to return to full physical activity after the second week. Inform the doctor who arranges the test of any previous allergic reaction to drugs, particularly those containing iodine. You will need to be generally healthy, and should be taken to and from hospital by car. Ideally arrange for someone to stay with you for a few days, and check that your general practitioner knows that the test is being carried out. What Happens during an AortographyTHE PRINCIPLEThis is quite simple. Dye (called contrast medium) contains iodine, which is opaque to x-rays. This is injected into an artery through a needle or thin plastic tube (called a catheter) and x-rays are then taken. The arteries being injected show up on the x-ray, and any narrowing or blockage will be seen. This allows the surgeon to decide if an operation is necessary. He can then plan the details of how the blockage will be dealt with.THE PROCEDUREThe test lasts about 2 hours and is carried out by an x-ray specialist (radiologist) who is medically qualified. On the day of the test, the you will be brought to the x-ray department and lie down on the x-ray table. A small injection of sedative and painkilling drugs is given in the hand or elbow to make you feel relaxed. Children and very nervous patients are given a general anaesthetic. Most arterial injections are made through the groin, which is shaved and cleaned. The area is then towelled-up by the nurse, as it would be in an operating theatre. Local anaesthetic is injected through a very thin needle until the area around the groin is numb. A larger needle is then passed into the artery and is usually replaced by the catheter. You will be aware that something is happening at the groin but will feel no pain (more local anaesthetic can be injected if the numbness begins to wear off before the test is finished). The arterial catheter shows up on an x-ray TV screen and can be directed into the appropriate artery by the radiologist. This is quite painless: still you will feel nothing apart from pressure at the groin. When the catheter is in the right place, the dye is injected and a series of x-rays are taken. The injection may produce a feeling of heat or flushing but this always disappears within a few seconds. The x-ray table moves so that the arteries of the legs can be x-rayed as far down as the feet. It is important to keep quite still when the x-rays are taken to avoid blurring the pictures.Several injections of dye are usually given and x-rays are taken at different angles. This is the longest part of the procedure and takes about an hour. When all the x-rays have been taken, the catheter or needle is removed from your groin. Pressure is applied to the groin for 10 minutes to prevent bleeding. You will then be lifted from the x-ray table onto a stretcher and will need to remain lying down for at least an hour to avoid the risk of any bleeding. If you are an outpatient and comfortable 2 hours after the end of the test, it is usually safe to dress carefully and to leave the hospital with a friend. Inpatients will be taken back to the ward as soon as the test is over and will be kept in bed for 3 4 hours. Occasionally the artery injection is made through the back (trans-lumbar aortography). These examinations are always carried out under general anaesthetic and you will have to stay in hospital for 24 hours afterwards. There may be some backache for a few hours or days afterwards. If a groin injection is for some reason not possible, the dye can also be given into the arm or armpit. This is rather more difficult to carry out: patients are always admitted to hospital and are kept in hospital for 24 hours afterwards. Quite unnoticed by you, the dye is gradually excreted in the urine over the next 24 hours. Possible Complications with an AortographyNormally, there is only some bruising where the injection was given. A small proportion of patients develop a large bruise at the groin which can take 2 3 weeks to clear completely. Injury to the artery can occur at the site of injection. This is more likely to happen if the artery is already badly diseased. Very rarely it can result in narrowing or even blockage of the artery which is being examined. In most cases, this problem improves without treatment. In view of this possible complication, you will usually be seen by a vascular surgeon beforehand and the risks and benefits of the angiogram discussed. If you have any questions about the x-ray, it is best to discuss these with the vascular surgeon who is looking after you. Allergic reactions to the sedative drugs and dye can occur. These can usually be quite simply treated with adrenaline, cortisone-like (steroid) drugs, or simple antihistamines. After an AortographyMost patients have a small bruise at the groin and there may be slight discomfort on moving the hip for a few days. You can return to work after a few days and to full physical activity after 2 weeks. If an Aortography is not performedThe test allows the surgeon to decide if an operation is necessary and to plan it carefully. The surgeon would not carry out an arterial operation on the legs without an angiogram, except in an emergency. At the moment there is no alternative which enables the surgeon to assess blood supply as accurately. |
|
| Join Our Mailing List |
| About Surgerydoor :: Privacy Statement :: Contact Us |