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Renal 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. A local anesthetic is given, 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 the main vessels of the abdomen and chest until it is properly placed in the arteries of the neck. 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 renal artery, through the catheter, 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. After the X-rays are taken, the needle and catheter are withdrawn. Pressure is immediately applied to 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 an additional 12 hours after the procedure.
How to Prepare:
Inform the health care provider if you are pregnant and if you have ever had any bleeding problems. Report any allergic reactions to X-ray contrast material or any iodine substance and any other allergic reactions you have had.
You must sign a consent form. Food and fluids will be restricted 8 hours before the test. You will be given a hospital gown to wear and asked to 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, there is a burning sensation.
Risks:
There is the possibility of significant risk. There is a chance of a reaction to the contrast medium. 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 . This is rare, however. 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 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 .
Why this Test is Performed:
The test is done to evaluate the blood vessels in the kidney before surgery. The test may detect stenosis (narrowing of the blood vessel), blood clots , or aneurysm (a sac filled with blood caused by a widening of the vein or artery). The test may help evaluate kidney disease or failure, tumors, or kidney tissue function. It is used to evaluate donors and recipients before transplantation of a kidney.
Normal Values:
The X-ray shows normal structures for the age of the patient.
Abnormal Results:
The renal angiography may show the presence of tumors, narrowing of the artery or aneurysms (a sac filled with blood caused by a widening of the vein or artery), blood clots , bleeding in the kidney, abscesses , or cysts .
Additional conditions under which the test may be performed:
Cost:
The estimated cost is $801 to $900.
Special Considerations:
The test should not be done if you are pregnant or tend to bleed.
The kidneys are responsible for removing wastes from the body, regulating electrolyte balance and blood pressure, and the stimulation of red blood cell production. The gross anatomical structure of the kidney is illustrated.
This is the typical appearance of the blood vessels (vasculature) and urine flow pattern in the kidney. The blood vessels are shown in red and the urine flow pattern in yellow.
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