Angiography is sometimes called conventional angiography to distinguish it from CT angiography (CTA) and magnetic resonance angiography (MRA). Angiography provides detailed images of blood vessels, commonly those in the heart, lungs, brain, and legs. Angiography can provide still images or motion pictures (called cineangiography).
IV contrast is injected through a catheter inserted into a blood vessel that connects with the vessel to be imaged. A local anesthetic or a sedative may be used. If the catheter is inserted into an artery, the insertion site must be steadily compressed for 10 to 20 min after all instruments are removed. Patients may need to lie flat for several hours or be hospitalized to reduce risk of bleeding at the puncture site. Angiography, although invasive, is relatively safe.
Angiography is the traditional gold standard for evaluating vascular lesions (eg, stenosis, obstruction, arteriovenous or other vascular malformations, aneurysms, dissections, sometimes vasculitis).
Angioplasty, stenting, and sometimes vascular repair can be done during angiography.
Digital subtraction angiography:
Images of arteries are taken before and after contrast injection; then a computer subtracts one image from the other. Images of structures other than arteries are thus eliminated, enabling the arteries to be seen more clearly.
Contrast reactions occasionally occur (see Principles of Radiologic Imaging: Radiographic Contrast Agents and Contrast Reactions).
The injection site may become infected or bleed, sometimes forming a painful hematoma. Rarely, an artery is injured by the catheter. Very rarely, shock, seizures, renal failure, and cardiac arrest occur. Risk of complications is higher in the elderly, although it is still low. The radiation dose used in angiography can vary and be significant (eg, coronary angiography is associated with an effective radiation dose of 4.6 to 15.8 mSv). Angiography must be done by highly skilled physicians, usually interventional radiologists.
Last full review/revision July 2008 by Jon A. Jacobson, MD
Content last modified February 2012