Angiography of the vessels of the lower extremities: how is it performed?

Vascular diseases are often diagnosed in the adult population. This is especially true of older people. There are also vascular pathologies, which are related to congenital diseases and develop in children. As is known, arteries and veins are necessary for the deposition and spread of blood throughout the body. If this function is not performed, oxygen starvation and ischemia are observed. The vessels of the heart, brain and lower limbs are most often affected. In most cases there is a violation of blood supply in several organs at once. The pathology of the vessels of the lower extremities is quite common among the female population. As a rule, there is a varicose disease. If the blood flow is suspected in the arteries or veins, angiography of the vessels of the lower extremities is performed. This diagnostic procedure is necessary to determine the extent of the lesion and its prevalence.

Angiography of the vessels of the lower extremities - what is it?

In order to find out how much the arteries or leg veins are affected, it is necessary to conduct a number of studies. One of them is the angiography of the vessels of the lower extremities. It refers to X-ray contrast diagnostic procedures. Thanks to this method of research, it is possible to judge where the site of the lesion is located, whether there are thrombi and stenosis of the arteries and veins. Angiography is considered an invasive procedure, since for its implementation it is necessary to introduce a contrast agent into the vascular bed. For this purpose, the artery or vein is punctured. For this reason, the study should be carried out under stationary conditions. Since X-rays can damage health, angiography has a number of contraindications. Nevertheless, this method allows a good examination of the vascular system and detect pathological processes. Currently, such a study is more advanced, it is often combined with computer and magnetic resonance imaging.

Angiography of lower extremity vessels: indications for

Despite the fact that angiography is considered a reliable diagnostic study, it is not performed by all comers. Given the radiographic load on the body and the invasiveness of the procedure, it should be resorted only in cases of acute necessity. The following indications for angiography are distinguished:

1. Blockage of vessels with cholesterol plaques. In this case, there is a narrowing of the lumen of the arteries and veins. Occlusion is observed in atherosclerotic vascular lesions. This disease is common in people suffering from metabolic syndrome, obesity. Pathology is often diagnosed in the elderly. In addition to the vessels of the lower extremities, atherosclerosis affects the arteries of the head and neck, heart and other organs.
2. Systemic vascular pathology. These include obliterating endarteritis, Lerish syndrome. With such diseases, the lumen of the vessels narrows due to stenosis. In severe cases, these pathologies can lead to a complete disruption of the patency of the arteries.
3. Different types of embolism, thrombosis. These disorders develop due to the entry of a blood clot, cholesterol plaque and other foreign substances into the lumen of the vessel( fat tissue, air bubbles).
4. Anomalies of veins or arteries. These include diverticulum of vessels, aneurysm, the presence of pathological anastomoses.
5. Varicose veins of lower extremities. It is characterized by the pathological tortuosity of the vessels, the appearance of sites of expansion and narrowing of the lumen.
6. Complications of diabetes mellitus. This disease is often accompanied by the defeat of the arteries and veins of the lower extremities. In severe cases, it leads to the development of gangrene.

Angiography of the vessels of the lower limbs is necessary when symptoms such as sudden pain along the artery and veins, their swelling or densification occur. In these cases, the research should be carried out as quickly as possible. If you suspect a chronic disease( atherosclerosis, complications of diabetes mellitus, varicose veins), which are not accompanied by severe clinical manifestations, this procedure is recommended in a planned manner in the absence of contraindications.

When is the angiography of the leg vessels performed according to the ICD?

All pathologies have a definite cipher in the International Classification of Diseases( ICD).Thus, doctors from any country determine which diagnosis was given to the patient. Not an exception and the pathology of the arteries and veins. Thanks to a special cipher, the doctor finds out whether there are indications for such a method of investigation as angiography of the vessels of the lower extremities. The code for ICD-10 is set after writing the diagnosis. Examples are the following pathologies:

1. Atherosclerosis of the arteries of the extremities. I70.2
2. Deep vein thrombosis. I80
3. Angiopathy of the lower extremities with diabetes. E10.5

When referring to a study, it is necessary to indicate not only the diagnosis, but also its code for ICD-10.This classification is generally accepted throughout the world.

Contraindications to angiography

Like all invasive diagnostic methods, angiography is performed with special indications. In some cases, this study can not be performed, even if the patient has the pathologies listed above. This is associated with a greater risk of complications, which can develop as a result of radiation exposure or the introduction of a contrast agent. Then it is recommended to replace the survey method. So, who should not undergo such a study as angiography of the vessels of the lower extremities? Contraindications are as follows:

1. Acute heart disease. These include unstable angina and myocardial infarction.
2. Chronic, severe heart failure.
3. Pregnancy and lactation.
4. Children under 2 years.
5. Severe diseases of internal organs. This group includes renal, respiratory and hepatic insufficiency.
6. Allergic reactions to iodine( since this substance is present in the contrast medium).
7. Diseases of the blood. Especially it concerns pathologies, in which coagulability is violated. An example is hemophilia, hemorrhagic vasculitis, thrombocytopenia.

Varieties of lower limb angiography

There are 2 variants of angiography. In the first case, the study is aimed at visualizing the veins of the lower extremities. It is called phlebography. In this case, the contrast is introduced only into the venous system, after which a number of radiographic photographs are taken.

Another variant of the study is arteriography. The principle of visualization of the vessels is the same. In rare cases, it is necessary to visualize both the veins and arteries of the lower extremities. In addition, the study can be carried out not only under the control of radiography, but also with the use of CT and MRI.In these cases, more accurate( detailed) angiography of the vessels of the lower extremities is obtained. The photos( pictures) taken by the X-ray machine are slightly different from the images taken with CT and MRI.

Preparation for angiography of the lower extremities

Given that the procedure refers to invasive methods, the patient must be prepared for this study. Before the angiography, a number of laboratory tests must be submitted. Among them: UAC, OAM, coagulogram, biochemical blood test. It is also important to explain to the person what the procedure is for and what risks are involved. Before conducting angiography, it is necessary to cancel antiplatelet therapy( a few days before the study).Preparation for examination includes:

1. Limitation of fluid intake.
2. Refusal to eat for several hours before the study. It is advisable not to eat in the evening, on the eve of the diagnostic procedure and in the morning.
3. Introduction of antihistamines in people with a predisposition to allergic reactions.
4. Taking sedatives before the test is recommended in the presence of emotional patient lability.

Technique for angiography of lower extremities

To visualize changes in the veins or arteries of the legs, angiography of the vessels of the lower extremities is necessary. How is this procedure carried out? First of all, it is necessary to treat the skin above the test solution with an antiseptic solution. After this, the artery or vein is punctured. Into the vessel introducer introduces - the special device thanks to which the blood does not flow out in the opposite direction. Further, a catheter is placed inside the examined artery or vein. On it, a contrast agent enters the vessel. After this, the radiography or computed tomography of the investigated artery sites( veins) is performed.

Reading the results of angiography

The result of the angiography is presented by an X-ray, which shows the vessels undergoing contrasting. The conclusion is made by a surgeon or a doctor of radiation diagnosis. According to X-ray images, it is possible to evaluate the course of arteries or veins, the presence or absence of thrombi, the degree of narrowing of the lumen, as well as the exact location of the damaged area. Normally, the contours of the vessels are even and equal on both legs.

Possible complications of angiography

Like any invasive manipulation, angiography of the vessels of the lower extremities is dangerous due to the development of complications. They are observed in rare cases( less than 5%).Complications include:

1. Bleeding from the puncture site of the vessel.
2. Infection of the wound.
3. Appearance of edema and bruising.
4. In rare cases, acute cardiac or renal failure may develop.

Reviews of doctors about the procedure

If there is a suspicion of acute circulatory disturbances in the arteries or veins of the legs and the absence of contraindications, angiography of the vessels of the lower extremities is indicated. The doctors' comments on this procedure are positive. Doctors note the quality and effectiveness of angiography in the diagnosis of thrombosis and stenosis of vessels of the lower limbs. The merits of this procedure include speed of its implementation( about 15 minutes) and a small risk of complications.