rteriography is a radiological examination of arteries using X-rays after injecting contrast medium into the arteries through a very thin hollow tube with special shapes called catheters. Arteries filled with contrast medium appear opaque under X-rays, and these cast a shadow which is captured on X-ray film. Arteries which can be examined include arteries of the limbs (called upper or lower limb angiography), arteries of the brain carotid angiography) and larger arteries in the chest and abdomen, including their branches. Arteriography of the heart vessels (coronary angiography) is usually performed by cardiologists. 

Arteriography is performed when any abnormality involving the blood vessels is suspected. This may be for diagnosis (e.g. finding the cause of bleeding in the brain), as an investigation prior to surgery ( e.g. in potential renal donors) or for therapeutic interventional procedure ( like embolisation of an arteriovenous malformation). Arteriography can be performed on most people if the situation warrants. However, it is not recommended that patients with bleeding problems undergo this examination. Like any other interventional procedure, arteriography carries a risk. The doctors must be informed of the patient’s detailed medical history, no matter how trivial. Consent needs to be obtained from the patient for an arteriogram.

The patient may be admitted into the hospital a day before the examination or come into hospital as an outpatient. The patient is required to fast overnight. However, if the patient is on any medication e.g. for diabetes or hypertension, it is advised that medication be taken with a little liquid. However, there are certain medications, which need to be stopped before the examination. It is advised that the patient informs the doctor of their daily medication. The area on the skin, which is usually punctured for insertion of the catheter, is the groin, although the radiologist may choose other sites like the wrist or the armpit. The skin over the chosen area will be shaved and cleaned before the examination.

Before the examination, a mild sedative will be given to the patient in order to reduce anxiety and help the patient to sleep. The patient may feel sleepy and it is all right if he sleeps throughout the examination. There will be a few people present in the examination room and they are all involved in the procedure. They are the radiologist, an assistant, the radiographer and a nurse. After being transferred on to the X-ray table, clean sheets will be placed over the patient and the patient is advised to keep their hands below the sheets. The radiologist will always be talking to the patient and informing him of what will be done during the examination. The area of puncture will be cleaned. A little local anaesthetic will be given into the site to numb the area and this may sting a bit initially. A small cut (4-6mm long) is made in the skin and a needle is used to puncture the artery. Through this needle, a guide wire will be passed after which the needle will then be removed. A catheter is then threaded over the wire and into the artery. The radiologist will then manoeuvre the catheter into the artery to be examined. During this time, the room may be dimmed to help the radiologist see the TV monitor better. The passage of catheter through the artery should not be felt. Contrast medium will then be injected and images (X-rays) taken. After all the necessary images are taken, the catheter is removed and a doctor will press on the puncture site for about 10 minutes until bleeding stops.

During the examination, you may feel a warm sensation when contrast medium is injected or a little discomfort at the puncture site when the doctor manipulates the catheter.

You will be taken back to your room. It is advised that the patient tries not to move the lower body and leg for the next 8 to 12 hours to avoid the clot at the puncture site from dislodging. Regular checks of the puncture site by the attending doctor or nurse is made to make sure bleeding is under control and to look out for side effects, should there be any. The attending staff should be alerted if the patient feels the groin is swollen or if excessive bleeding from the puncture site occurs.

One may develop a haematoma at the site of puncture if the bleeding is not well controlled. The patient may also pass more urine than usual as a result of contrast medium injected. However, complications are not common as the radiologists involved in the procedure are trained to take maximal care during the examination.

If everything is stable, the patient is allowed to go home the following day.

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Last Updated:
Thursday, 21 August, 2003