Extremity arteriography

How the Test is Performed:
This test is done in the hospital. You will be asked to lie on the X-ray table. The area where the contrast medium will be introduced is shaved and cleansed. The site is usually in the leg. You are given a local anesthetic, the artery is punctured, and a needle is inserted into the artery. The catheter (a long, narrow, flexible tube) is inserted through the needle and into the artery. It is then threaded through until it is in the artery needed. This procedure is monitored by a fluoroscope (a special X-ray that projects the images on a TV monitor). The contrast medium is then injected into the artery, and the X-ray pictures are taken. The catheter is kept open by flushing it periodically with a saline solution containing heparin, which will keep the blood in the catheter from clotting. The pulse (heart rate) , blood pressure , and breathing are monitored during the procedure. After the x-rays are taken, the needle and catheter are withdrawn. Pressure is immediately applied on the leg at the site of insertion for 10 to 15 minutes to stop the bleeding . After that time, the area is checked and a tight bandage is applied. The leg should be kept straight for 12 hours after the procedure.

How to Prepare:
Food and fluids will be restricted 8 hours before the test is done. Advise the health care provider if you are pregnant or bleeding problems have occurred in the past. Inform your health care provider of any allergic reactions to X-ray contrast material, iodine substance, or other allergic reactions. You must sign a consent form. You will be given a gown to wear. Remove all jewelry. You may be given a sedative or pain pill before the procedure.

Infants and children:
The physical and psychological preparation you can provide for this or any test or procedure depends on your child's age, interests, previous experience, and level of trust. For specific information regarding how you can prepare your child, see the following topics as they correspond to your child's age:



How it Feels:
The X-ray table is hard and cold; you may ask for a blanket or pillow. There is a sting when the anesthetic is given. This does not numb the artery, so there will be brief, sharp pain as the catheter is inserted. There is a feeling of pressure as the catheter is advanced. As the dye is injected a burning sensation occurs. There is often tenderness and bruising at the site of the injection after the test.

Risks:
There is the possibility of some significant risk. A reaction to the contrast medium can occur. There is some risk of the catheter damaging the artery or knocking loose a piece of the artery wall which can block the blood flow and cause a stroke ; however, this is rare. A clot or bleeding at the puncture site may result in a partial blockage of the flow of blood to the leg.

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

Why this Test is Performed:
The extremities arteriogram helps identify and locate occlusions (closure of the vessel). The test is done when a person has symptoms of vascular disease in the extremity.

Normal Values:
The X-ray shows normal structures for the age of the patient.

Abnormal Results:
The X-ray may show blockage in the vessels caused by hardening of the arteries (arteriosclerotic occlusion), blood clots , diseases of the arteries, and aneurysms (sacs filled with blood that have formed because of an abnormal widening in the artery).

Additional conditions under which the test may be performed:



Cost:
The estimated cost is $400 to $500.

Special Considerations:
Not applicable.