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

Vascular disease is often diagnosed in the adult population. This is especially true of the elderly. There are also vascular pathologies that relate to congenital diseases and develop in children. As you know, arteries and veins are necessary for the deposition and distribution of blood throughout the body. If this function is not carried out, oxygen starvation and ischemia are observed. Most often, the vessels of the heart, brain and lower extremities are affected. In most cases, there is a violation of blood supply in several organs at once. Pathologies of the vessels of the lower extremities are quite common among the female population. As a rule, there is varicose disease. If blood flow in the arteries or veins is suspected, angiography of the vessels of the lower extremities is performed. This diagnostic procedure is necessary to determine the degree of damage and its prevalence.

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

In order to find out how much the arteries or veins of the legs are affected, a number of studies are needed. One of them is angiography of the vessels of the lower extremities. It refers to radiopaque diagnostic procedures. Thanks to this research method, one can judge where the lesion is located, whether there are blood clots and stenosis of 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, a puncture of an artery or vein is performed. For this reason, the study should be carried out in stationary conditions. Since X-rays can be harmful to health, angiography has a number of contraindications. Nevertheless, this method allows you to clearly see the vascular system and detect pathological processes. Currently, such a study is more advanced, often combined with computed tomography and magnetic resonance imaging.

Angiography of vessels of the lower extremities: indications for

Despite the fact that angiography is considered a reliable diagnostic study, it is not performed for everyone. Given the radiological burden on the body and the invasiveness of the procedure, it should be resorted to only in cases of urgent need. The following indications for angiography are distinguished:

1. Vascular blockage with cholesterol plaques. In this case, there is a narrowing of the lumen of the arteries and veins. Blockage occurs with atherosclerotic vascular disease. 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’s syndrome. With such diseases, there is a narrowing of the lumen of the vessels due to stenosis. In severe cases, these pathologies can lead to a complete violation of patency of the arteries.
3. Different types of embolism, thrombosis. These disorders develop as a result of a blood clot, cholesterol plaque and other foreign substances (adipose tissue, air bubbles) entering the lumen of the vessel.
4. Anomalies of the veins or arteries. These include vascular diverticula, aneurysm, the presence of pathological anastomoses.
5. Varicose veins. It is characterized by pathological tortuosity of blood vessels, the appearance of areas of expansion and narrowing of the lumen.
6. Complications of diabetes. This disease is often accompanied by damage to 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 extremities is necessary when symptoms such as sudden pain along the artery and veins, their bloating or tightening appear. In these cases, the study needs to be done 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 angiography of the vessels of the legs according to the ICD?

All pathologies have a certain code in the international classification of diseases (ICD). Thus, doctors from any country determine what diagnosis was made to the patient. The pathology of arteries and veins is no exception. Thanks to a special cipher, the doctor finds out if there are indications for such a research method as angiography of the vessels of the lower extremities. The ICD-10 code is put after the diagnosis is written. Examples are the following pathologies:

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

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

Contraindications for angiography

Like all invasive diagnostic methods, angiography is performed with special indications. In some cases, this study cannot be performed, even if the patient has the pathologies listed above. This is associated with a greater risk of complications that may develop due to radiation exposure or the administration of a contrast medium. Then it is recommended to replace the examination 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. Severe chronic heart failure.
3. Pregnancy and lactation.
4. Children's age up to 2 years.
5. Severe diseases of the internal organs. This group includes renal, respiratory and liver failure.
6. Allergic reactions to iodine (since this substance is part of a contrast medium).
7. Blood disease. This is especially true for pathologies in which coagulation is impaired. An example is hemophilia, hemorrhagic vasculitis, thrombocytopenia.

Varieties of angiography of the vessels of the lower extremities

There are 2 options for 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 images are taken.

Another option for the study is arteriography. The principle of vascular imaging is the same. In rare cases, it is necessary to visualize both veins and arteries of the lower extremities. In addition, the study can be carried out not only under the control of radiography, but also using CT and MRI devices. In these cases, a more accurate (detailed) angiography of the vessels of the lower extremities is obtained. Photos (pictures) taken by an X-ray machine are somewhat different from images taken with CT and MRI.

Preparation for lower limb angiography

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

1. Restriction 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. The introduction of antihistamines in people with a predisposition to allergic reactions.
4. Taking sedatives before the study is recommended in the presence of emotional lability of the patient.

Lower limb angiography technique

In order 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? The first step is to treat the skin over the test vessel with an antiseptic solution. After this, an artery or vein is punctured. An introducer is introduced into the vessel - a special device due to which the blood does not flow out in the opposite direction. Next, a catheter is placed inside the test artery or vein. Through it, a contrast agent enters the vessel. After this, an x-ray or computed tomography of the studied areas of the artery (vein) is performed.

Reading Angiography Results

The result of angiography is represented by an x-ray, which shows the vessels subjected to contrast. The conclusion is made by a surgeon or a doctor of radiation diagnosis. X-ray images can be used to evaluate the course of arteries or veins, the presence or absence of blood clots, the degree of narrowing of the lumen, and the exact location of the damaged area. Normally, the contours of the vessels are even and the same on both legs.

Possible complications of angiography

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

1. Bleeding from a puncture site.
2. Wound infection.
3. The appearance of edema and hematoma.
4. In rare cases, acute heart or kidney failure may develop.

Reviews of doctors about the procedure

If acute circulatory disorders in the arteries or veins of the legs are suspected and there are no contraindications, angiography of the vessels of the lower extremities is indicated. Reviews of doctors about this procedure are positive. Doctors note the quality and effectiveness of angiography in the diagnosis of thrombosis and stenosis of the vessels of the lower extremities. The advantages of this procedure include the speed of its implementation (about 15 minutes) and a low risk of complications.