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[[Image:Cerebral angiography, arteria vertebralis sinister injection.JPG|right|thumb|250px|Angiogram showing a [[Transverse plane|transverse projection]] of the [[vertebral artery|vertebro]][[basilar artery|basilar]] and [[posterior cerebral]] circulation.]]
[[Image:Cerebral angiography, arteria vertebralis sinister injection.JPG|right|thumb|250px|Angiogram showing a [[Transverse plane|transverse projection]] of the [[vertebral artery|vertebro]][[basilar artery|basilar]] and [[posterior cerebral]] circulation.]]
[[Image:Angiogram WHO 933.jpg|thumb|right|150px|Patient about to undergo an angiogram, image courtesy of WHO.]]
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'''Angiography''' or '''arteriography''' is a [[medical imaging]] technique in which an [[X-ray]] picture is taken to visualize the inner opening ([[lumen (anatomy)|lumen]]) of blood filled structures, including [[artery|arteries]], [[vein]]s and the [[heart chamber]]s.  Its name comes from the [[Greek language|Greek]] words ''angeion'', "vessel", and ''graphien'', "to write or record". The X-ray film or image of the [[blood vessel]]s is called an '''angiograph''', or more commonly, an '''angiogram'''.
'''Angiography''' or '''arteriography''' is a [[medical imaging]] technique in which an [[X-ray]] picture is taken to visualize the inner opening ([[lumen (anatomy)|lumen]]) of blood filled structures, including [[artery|arteries]], [[vein]]s and the [[heart chamber]]s.  Its name comes from the [[Greek language|Greek]] words ''angeion'', "vessel", and ''graphien'', "to write or record". The X-ray film or image of the [[blood vessel]]s is called an '''angiograph''', or more commonly, an '''angiogram'''.


==History==
==Historical Aspect==
[[Image:Angiogram WHO 933.jpg|thumb|left|80px|Patient about to undergo an angiogram, image courtesy of WHO.]]
 
The term '''angiography''', or '''angeiography''', was originally used of a description of the [[weight]]s, [[Units of measurement|measures]], vessels, etc, used by several nations.
 
The Portuguese physician and neurologist Egas Moniz, [[Nobel Prize]] winner in 1949, developed in 1927 the technique of contrasted x-ray [[cerebral angiography]] to diagnose several kinds of nervous diseases, such as tumors and arteriovenous malformations.  
The Portuguese physician and neurologist Egas Moniz, [[Nobel Prize]] winner in 1949, developed in 1927 the technique of contrasted x-ray [[cerebral angiography]] to diagnose several kinds of nervous diseases, such as tumors and arteriovenous malformations.  


He is usually recognized as one of the pioneers in this field. With the introduction of the [[Seldinger technique]] in 1953, the procedure became markedly safer as no sharp introductory devices needed to remain inside the vascular lumen.
He is usually recognized as one of the pioneers in this field.  
 
With the introduction of the [[Seldinger technique]] in 1953, the procedure became markedly safer as no sharp introductory devices needed to remain inside the vascular lumen.
<br clear="left"/>


==Methods==
==Methods==
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Angiography is also commonly performed to identify vessel [[stenosis|narrowing]] in patients with [[retina]]l vascular disorders, such as [[diabetic retinopathy]] and [[macular degeneration]].
Angiography is also commonly performed to identify vessel [[stenosis|narrowing]] in patients with [[retina]]l vascular disorders, such as [[diabetic retinopathy]] and [[macular degeneration]].
==Clinical Applications==
===Coronary Angiography===
{{main|Coronary angiography}}
One of most common angiograms performed is to visualize the blood in the [[coronary artery|coronary arteries]]. A long, thin, flexible tube called a [[catheter]] is used to administer the x-ray contrast agent at the desired area to be visualized. The catheter is threaded into an artery in the [[groin]] or [[forearm]], and the tip is advanced through the arterial system into one of the two major coronary arteries. 
[[X-ray]] images of the transient [[radiocontrast]] distribution within the blood flowing within the coronary arteries allows visualization of the size of the artery [[lumen (anatomy)|openings]]. Presence or absence of [[atherosclerosis]] or [[atheroma]] within the walls of the [[artery|arteries]] cannot be clearly determined. See [[coronary catheterization]] for more detail..
===Neuro-vascular angiography===
Another increasingly common angiographic procedure is neuro-vascular [[digital subtraction angiography]] in order to visualise the arterial and venous supply to the brain. Intervention work such as coil-embolisation of [[aneurysm]]s and [[Arteriovenous malformation|AVM]] gluing can also be performed
===Peripheral Angiography===
{{main|Peripheral artery occlusive disease}}
Angiography is also commonly performed to identify vessel [[stenosis|narrowing]] in patients with leg claudication or ''cramps'', caused by reduced blood flow down the legs and to the feet; in patients with renal stenosis (which commonly causes high blood pressure) and can be used in the head to find and repair stroke. These are all done routinely through the femoral artery, but can also be performed through the brachial or axillary (arm) artery.  Any stenoses found may be treated by the use of [[angioplasty]].
===Other===
Other angiographic uses include the diagnosis of [[retina]]l vascular disorders, such as [[diabetic retinopathy]] and [[macular degeneration]].


==Types of angiographs==
==Types of angiographs==
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[[Image:Ha1.jpg|thumb|300px|left|A [[coronary angiogram]] (an X-ray with radio-opaque contrast in the coronary arteries) that shows the left [[coronary circulation]].  The distal [[left main coronary artery]] (LMCA) is in the left upper quadrant of the image.  Its main branches (also visible) are the [[left circumflex artery]] (LCX), which courses top-to-bottom initially and then toward the centre/bottom, and the [[left anterior descending]] (LAD) artery, which courses from left-to-right on the image and then courses down the middle of the image to project underneath of the distal LCX.  The LAD, as is usual, has two large diagonal branches, which arise at the centre-top of the image and course toward the centre/right of the image.]]
[[Image:Ha1.jpg|thumb|300px|left|A [[coronary angiogram]] (an X-ray with radio-opaque contrast in the coronary arteries) that shows the left [[coronary circulation]].  The distal [[left main coronary artery]] (LMCA) is in the left upper quadrant of the image.  Its main branches (also visible) are the [[left circumflex artery]] (LCX), which courses top-to-bottom initially and then toward the centre/bottom, and the [[left anterior descending]] (LAD) artery, which courses from left-to-right on the image and then courses down the middle of the image to project underneath of the distal LCX.  The LAD, as is usual, has two large diagonal branches, which arise at the centre-top of the image and course toward the centre/right of the image.]]
<br clear="left"/>
<br clear="left"/>
==Historic usage==


The term '''angiography''', or '''angeiography''', was originally used of a description of the [[weight]]s, [[Units of measurement|measures]], vessels, etc, used by several nations.
==Postmortem Angiograms: Coronary Arteries ==
 
[http://www.peir.net Images courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology] </small>
 
<gallery perRow="3">
Image:Postmortem angiogram of coronary arteries 1.jpg|Myocardial Infarction: Postmortem angiogram of coronary arteries
Image:Postmortem angiogram of coronary arteries 2.jpg|Angiogram: X-ray, horizontal sections of ventricle showing penetrating artery distribution (a quite good example)
Image:Postmortem angiogram of coronary arteries 3.jpg|Angiogram: X-ray, postmortem coronary arteries with multiple lesions
Image:Postmortem angiogram of coronary arteries 4.jpg|Angiogram: X-ray postmortem normal coronaries
Image:Postmortem angiogram of coronary arteries 5.jpg|Angiogram: Postmortem angiogram with apparent lesions in proximal right coronary artery
Image:Postmortem angiogram of coronary arteries 6.jpg|Angiogram: X-ray, postmortem injection horizontal slice of left ventricle showing very well penetrating arteries
Image:Postmortem angiogram of coronary arteries 7.jpg|Angiogram Saphenous Vein Bypass Graft: X-ray shows rather close-up large vein anastomosing to much smaller artery
Image:Postmortem angiogram of coronary arteries 8.jpg|Angiogram Saphenous Vein Bypass Graft: X-ray postmortem injection showing vein anastomosis very well and the vasculature of the right and left ventricles
Image:Postmortem angiogram of coronary arteries 9.jpg|Coronary artery: Atherosclerosis: X-ray postmortem extensive lesions in this x-ray of whole heart
Image:Postmortem angiogram of coronary arteries 10.jpg|X-Ray Intramyocardial Arteries: X-ray three horizontal slices of ventricles showing quite well the penetrating arteries
Image:Postmortem angiogram of coronary arteries 11.jpg|X-Ray Intramyocardial Arteries: X-ray three horizontal slices of ventricles showing quite well the penetrating arteries
Image:Postmortem angiogram of coronary arteries 12.jpg|Coronary Artery Anomalous Origin; Left From Pulmonary Artery: Angiogram, postmortem, after switch of left coronary artery to aorta
Image:Postmortem angiogram of coronary arteries 14.jpg|Coronary artery: Atherosclerosis: X-ray, postmortem, dissected arteries and extensive lesions 
Image:Postmortem angiogram of coronary arteries 15.jpg|Coronary artery: Atherosclerosis: X-ray, postmortem, close-up view of artery with extensive lesions (very good example)
Image:Postmortem angiogram of coronary arteries 16.jpg|Coronary artery: Atherosclerosis: X-ray, postmortem, dissected artery, lesions in small branches 
</gallery>


==External links==
==External links==
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* [http://www.emdmedical.com/ Worldwide Angiography Manufacturer ]
* [http://www.emdmedical.com/ Worldwide Angiography Manufacturer ]


{{SIB}}
{{Coronary Angiography}}
 
[[Category:Cardiovascular system]]
[[Category:Cardiology]]
[[Category:Radiology]]
[[Category:Surgery]]
[[Category:Medical imaging]]
[[Category:Cardiology]]


[[cs:Angiografie]]
[[cs:Angiografie]]
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Latest revision as of 21:12, 14 March 2016

Angiogram showing a transverse projection of the vertebrobasilar and posterior cerebral circulation.
Patient about to undergo an angiogram, image courtesy of WHO.

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

Angiography or arteriography is a medical imaging technique in which an X-ray picture is taken to visualize the inner opening (lumen) of blood filled structures, including arteries, veins and the heart chambers. Its name comes from the Greek words angeion, "vessel", and graphien, "to write or record". The X-ray film or image of the blood vessels is called an angiograph, or more commonly, an angiogram.

Historical Aspect

The term angiography, or angeiography, was originally used of a description of the weights, measures, vessels, etc, used by several nations.

The Portuguese physician and neurologist Egas Moniz, Nobel Prize winner in 1949, developed in 1927 the technique of contrasted x-ray cerebral angiography to diagnose several kinds of nervous diseases, such as tumors and arteriovenous malformations.

He is usually recognized as one of the pioneers in this field.

With the introduction of the Seldinger technique in 1953, the procedure became markedly safer as no sharp introductory devices needed to remain inside the vascular lumen.

Methods

Angiograms require the insertion of a catheter into a peripheral artery, e.g. the femoral artery.

As blood has the same radiodensity as the surrounding tissues, a radiocontrast agent (which absorbs X-rays) is added to the blood to make angiography visualization possible. The angiographic X-ray image shows shadows of the openings within the cardiovascular structures carrying blood (actually the radiocontrast agent within). The blood vessels or heart chambers themselves remain largely to totally invisible on the X-ray image.

The X-ray images may be taken as either still images, displayed on a fluoroscope or film, useful for mapping an area. Alternatively, they may be motion images, usually taken at 30 frames per second, which also show the speed of blood (actually the speed of radiocontrast within the blood) traveling within the blood vessel.

The most common angiogram performed is to visualize the blood in the coronary arteries. A long, thin, flexible tube called a catheter is used so as to administer the radiocontrast agent at the desired area to be visualized. The catheter is threaded into an artery in the groin or forearm, and the tip is advanced through the arterial system into one of the two major coronary arteries. X-ray images of the transient radiocontrast distribution within the blood flowing within the coronary arteries allows visualization of the size of the artery openings. Presence or absence of atherosclerosis or atheroma within the walls of the arteries cannot be clearly determined. See coronary catheterization for more detail.

Angiography is also commonly performed to identify vessel narrowing in patients with retinal vascular disorders, such as diabetic retinopathy and macular degeneration.

Clinical Applications

Coronary Angiography

Main article: Coronary angiography

One of most common angiograms performed is to visualize the blood in the coronary arteries. A long, thin, flexible tube called a catheter is used to administer the x-ray contrast agent at the desired area to be visualized. The catheter is threaded into an artery in the groin or forearm, and the tip is advanced through the arterial system into one of the two major coronary arteries.

X-ray images of the transient radiocontrast distribution within the blood flowing within the coronary arteries allows visualization of the size of the artery openings. Presence or absence of atherosclerosis or atheroma within the walls of the arteries cannot be clearly determined. See coronary catheterization for more detail..

Neuro-vascular angiography

Another increasingly common angiographic procedure is neuro-vascular digital subtraction angiography in order to visualise the arterial and venous supply to the brain. Intervention work such as coil-embolisation of aneurysms and AVM gluing can also be performed

Peripheral Angiography

Main article: Peripheral artery occlusive disease

Angiography is also commonly performed to identify vessel narrowing in patients with leg claudication or cramps, caused by reduced blood flow down the legs and to the feet; in patients with renal stenosis (which commonly causes high blood pressure) and can be used in the head to find and repair stroke. These are all done routinely through the femoral artery, but can also be performed through the brachial or axillary (arm) artery. Any stenoses found may be treated by the use of angioplasty.

Other

Other angiographic uses include the diagnosis of retinal vascular disorders, such as diabetic retinopathy and macular degeneration.

Types of angiographs

A coronary angiogram (an X-ray with radio-opaque contrast in the coronary arteries) that shows the left coronary circulation. The distal left main coronary artery (LMCA) is in the left upper quadrant of the image. Its main branches (also visible) are the left circumflex artery (LCX), which courses top-to-bottom initially and then toward the centre/bottom, and the left anterior descending (LAD) artery, which courses from left-to-right on the image and then courses down the middle of the image to project underneath of the distal LCX. The LAD, as is usual, has two large diagonal branches, which arise at the centre-top of the image and course toward the centre/right of the image.


Postmortem Angiograms: Coronary Arteries

Images courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology

  • Myocardial Infarction: Postmortem angiogram of coronary arteries

    Myocardial Infarction: Postmortem angiogram of coronary arteries

  • Angiogram: X-ray, horizontal sections of ventricle showing penetrating artery distribution (a quite good example)

    Angiogram: X-ray, horizontal sections of ventricle showing penetrating artery distribution (a quite good example)

  • Angiogram: X-ray, postmortem coronary arteries with multiple lesions

    Angiogram: X-ray, postmortem coronary arteries with multiple lesions

  • Angiogram: X-ray postmortem normal coronaries

    Angiogram: X-ray postmortem normal coronaries

  • Angiogram: Postmortem angiogram with apparent lesions in proximal right coronary artery

    Angiogram: Postmortem angiogram with apparent lesions in proximal right coronary artery

  • Angiogram: X-ray, postmortem injection horizontal slice of left ventricle showing very well penetrating arteries

    Angiogram: X-ray, postmortem injection horizontal slice of left ventricle showing very well penetrating arteries

  • Angiogram Saphenous Vein Bypass Graft: X-ray shows rather close-up large vein anastomosing to much smaller artery

    Angiogram Saphenous Vein Bypass Graft: X-ray shows rather close-up large vein anastomosing to much smaller artery

  • Angiogram Saphenous Vein Bypass Graft: X-ray postmortem injection showing vein anastomosis very well and the vasculature of the right and left ventricles

    Angiogram Saphenous Vein Bypass Graft: X-ray postmortem injection showing vein anastomosis very well and the vasculature of the right and left ventricles

  • Coronary artery: Atherosclerosis: X-ray postmortem extensive lesions in this x-ray of whole heart

    Coronary artery: Atherosclerosis: X-ray postmortem extensive lesions in this x-ray of whole heart

  • X-Ray Intramyocardial Arteries: X-ray three horizontal slices of ventricles showing quite well the penetrating arteries

    X-Ray Intramyocardial Arteries: X-ray three horizontal slices of ventricles showing quite well the penetrating arteries

  • X-Ray Intramyocardial Arteries: X-ray three horizontal slices of ventricles showing quite well the penetrating arteries

    X-Ray Intramyocardial Arteries: X-ray three horizontal slices of ventricles showing quite well the penetrating arteries

  • Coronary Artery Anomalous Origin; Left From Pulmonary Artery: Angiogram, postmortem, after switch of left coronary artery to aorta

    Coronary Artery Anomalous Origin; Left From Pulmonary Artery: Angiogram, postmortem, after switch of left coronary artery to aorta

  • Coronary artery: Atherosclerosis: X-ray, postmortem, dissected arteries and extensive lesions

    Coronary artery: Atherosclerosis: X-ray, postmortem, dissected arteries and extensive lesions

  • Coronary artery: Atherosclerosis: X-ray, postmortem, close-up view of artery with extensive lesions (very good example)

    Coronary artery: Atherosclerosis: X-ray, postmortem, close-up view of artery with extensive lesions (very good example)

  • Coronary artery: Atherosclerosis: X-ray, postmortem, dissected artery, lesions in small branches

    Coronary artery: Atherosclerosis: X-ray, postmortem, dissected artery, lesions in small branches

External links

cs:Angiografie de:Angiografie it:Angiografia nl:Angiografie no:Angiografi fi:Angiografia


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