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(Angiogram-Pulmonary, Pulmonary Angiography, Pulmonary Arteriogram, Pulmonary Arteriography, Angiogram of the Lungs)
An angiogram, also called an arteriogram, is an x-ray image of the blood vessels. It is performed to evaluate various vascular conditions, such as an aneurysm (ballooning of a blood vessel), stenosis (narrowing of a blood vessel), or blockages.
A pulmonary angiogram is an angiogram of the blood vessels of the lungs. A pulmonary angiogram may be used to assess the blood flow to the lungs. One of the primary indications for the procedure is the diagnosis of a pulmonary embolus (clot). It may also be used to deliver medication into the lungs to treat cancer or hemorrhage.
In order to obtain a radiographic (x-ray) image of a blood vessel, an intravenous (IV) access is necessary so that a contrast dye can be injected into the body’s circulatory system, which includes the pulmonary (lungs) circulatory system. This contrast dye causes the blood vessels to be visible on x-ray film. This allows the physician to see the size, shape, and many branches of the pulmonary vessels, in particular, the pulmonary artery that circulates blood to the lungs.
Fluoroscopy is often used during a pulmonary angiogram. Fluoroscopy is the study of moving body structures - similar to an x-ray “movie.” A continuous x-ray beam is passed through the body part being examined, and is transmitted to a TV-like monitor so that the body part and its motion can be seen in detail.
An additional technology that may be used with an angiogram is called digital subtraction angiography (DSA). Instead of using x-rays, DSA is based on computer imaging. DSA still requires a contrast dye to be injected into the pulmonary circulation. However, with DSA, a computer image is made prior to the injection of the dye. A computer digitally subtracts (or removes) everything from the image except that which is injected with the contrast dye, so that the computer image remaining is one of the pulmonary blood vessels only.
Other related procedures that may be used to diagnose problems of the chest and respiratory tract include chest x-rays, computed tomography (CT scan) of the chest, bronchoscopy, bronchography, chest fluoroscopy, chest ultrasound, lung biopsy, lung scan, mediastinoscopy, positron emission tomography (PET scan) of the chest, pleural biopsy, and thoracentesis. Please see these procedures for additional information.
The respiratory system is made up of the organs involved in the interchanges of gases, and consists of the:
The upper respiratory tract includes the:
The lower respiratory tract includes the lungs, bronchi, and alveoli.
The lungs take in oxygen, which cells need to live and carry out their normal functions. The lungs also get rid of carbon dioxide, a waste product of the body's cells.
The lungs are a pair of cone-shaped organs made up of spongy, pinkish-gray tissue. They take up most of the space in the chest, or the thorax (the part of the body between the base of the neck and diaphragm).
The lungs are enveloped in a membrane called the pleura.
The lungs are separated from each other by the mediastinum, an area that contains the following:
The right lung has three sections, called lobes. The left lung has two lobes. When you breathe, the air enters the body through the nose or the mouth. It then travels down the throat through the larynx (voice box) and trachea (windpipe) and goes into the lungs through tubes called main-stem bronchi.
One main-stem bronchus leads to the right lung and one to the left lung. In the lungs, the main-stem bronchi divide into smaller bronchi and then into even smaller tubes called bronchioles. Bronchioles end in tiny air sacs called alveoli.
A pulmonary angiogram may be performed to visualize the pulmonary vascular system, to evaluate for abnormalities, and to determine pressures within the pulmonary circuit. One of the most common reasons is to confirm the presence of a pulmonary embolus (clot) in one or more of the blood vessels in the lungs.
Abnormalities that may be detected by a pulmonary angiogram include, but are not limited to, the following:
A pulmonary angiogram may be used to evaluate the blood vessels and blood flow in the lungs before and/or after surgery or other procedures involving the blood vessels.
There may be other reasons for your physician to recommend a pulmonary angiogram.
You may want to ask your physician about the amount of radiation used during the procedure and the risks related to your particular situation. It is a good idea to keep a record of your past history of radiation exposure, such as previous scans and other types of x-rays, so that you can inform your physician. Risks associated with radiation exposure may be related to the cumulative number of x-ray examinations and/or treatments over a long period of time.
If you are pregnant or suspect that you may be pregnant, you should notify your physician. Radiation exposure during pregnancy may lead to birth defects.
There is a risk for allergic reaction to the dye. Patients who are allergic to or sensitive to medications, contrast dye, or iodine should notify their physician. Also, patients with kidney failure or other kidney problems should notify their physician.
Because the procedure involves the blood vessels and blood flow of the lungs and chest, there is a small risk for complications involving these structures. These complications may include, but are not limited to, the following:
There may be other risks depending upon your specific medical condition. Be sure to discuss any concerns with your physician prior to the procedure.
A pulmonary angiogram may be performed on an outpatient basis or as part of your stay in a hospital. Procedures may vary depending on your condition and your physician’s practices.
Generally, a pulmonary angiogram follows this process:
After the procedure, you will be taken to the recovery room for observation. The circulation and sensation of the limb where the injection catheter was inserted will be monitored. A nurse will monitor your vital signs and the injection site while you are in the recovery room.
You will remain flat in bed in a recovery room for several hours after the procedure. If the groin or arm site was used, the leg or arm on the side of the injection site will be kept straight for several hours.
You may be given pain medication for pain or discomfort related to the injection site or having to lie flat and still for a prolonged period.
You will be encouraged to drink water and other fluids to help flush the contrast dye from your body.
You may resume your usual diet after the procedure, unless your physician decides otherwise.
When you have completed the recovery period, you may be returned to your hospital room or discharged to your home. If this procedure was performed on an outpatient basis, you should plan to have another person drive you home.
Once at home, you should monitor the injection site for bleeding, unusual pain, swelling, and abnormal discoloration or temperature change at or near the injection site. A small bruise is normal, as is an occasional drop of blood at the site. If you notice a constant or large amount of blood at the site that cannot be contained with a small dressing, notify your physician.
If the groin or arm was used, you should monitor the leg or arm for changes in temperature or color, pain, numbness, tingling, or loss of function of the limb.
Drink plenty of fluids to prevent dehydration and to help pass the contrast dye.
You may be advised not to do any strenuous activities or take a hot bath or shower for a period of time after the procedure.
Notify your physician to report any of the following:
Your physician may give you additional or alternate instructions after the procedure, depending on your particular situation.
The content provided here is for informational purposes only, and was not designed to diagnose or treat a health problem or disease, or replace the professional medical advice you receive from your physician. Please consult your physician with any questions or concerns you may have regarding your condition.
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