| Subject | Contents |
| Definition | The extremities refer to the hands, arms, feet, and legs. The arteries are not normally seen in an X-ray , so a contrast material is injected into one or more arteries to make them visible. X-rays are then taken of the blood flow through the area of interest. X-rays are a form of electromagnetic radiation (like radio waves or light). The wavelength is very short and is capable of penetrating the body and producing a shadow picture of the structures inside the body. Some of the X-rays are absorbed by the body tissues, while other X-rays will pass through. The denser tissues, such as a bone, appear on the film as white. Less dense tissues, such as muscles, appear as gray; and air on the X-ray appears as black. |
| Alternative Names | Angiography/arteriography of the extremity
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| How the test is performed | This test is done in a hospital or outpatient facility. You will be asked to lie on the X-ray table. The area where the catheter will be inserted is shaved and cleansed. The site is usually in the groin area. You are given a local anesthetic, and a needle is used to puncture the artery. The catheter (a long, narrow, flexible tube) is inserted through the needle and into the artery. It is then threaded until it is in the artery of interest. This procedure is monitored by a fluoroscope (a special X-ray that projects dynamic images on a TV monitor). The contrast medium is then injected into the artery, and the X-ray pictures are taken. The catheter is kept open by flushing it periodically with a saline solution, which will keep the blood in the catheter from clotting. The pulse (heart rate) , blood pressure , and breathing are monitored during the procedure. After the x-rays are taken, the needle and catheter are withdrawn. Pressure is immediately applied on the leg at the site of insertion for 10 to 15 minutes to stop the bleeding . After that time, the area is checked and a bandage is applied. The leg should be kept straight for 6 hours after the procedure, and strenuous activity, such as heavy lifting, should be avoided for 24 to 48 hours. |
| How to prepare for the test | Food and fluids will be restricted 8 hours before the test is done. Advise the health care provider if you are pregnant or bleeding problems have occurred in the past. Some medications, such as aspirin or other blood thinners, may need to be stopped before the examination. Inform your health care provider of any allergic reactions to X-ray contrast material, iodine substance, or other allergic reactions. You must sign a consent form. You will be given a gown to wear. Remove all jewelry. You may be given a sedative or pain pill before the procedure. Infants and children: The physical and psychological preparation you can provide for this or any test or procedure depends on your child's age, interests, previous experience, and level of trust. For specific information regarding how you can prepare your child, see the following topics as they correspond to your child's age: Infant test or procedure preparation (birth to 1 year) Toddler test or procedure preparation (1 to 3 years) Preschooler test or procedure preparation (3 to 6 years) Schoolage test or procedure preparation (6 to 12 years) Adolescent test or procedure preparation (12 to 18 years) |
| How the test will feel | The X-ray table is hard and cold. You may ask for a blanket or pillow. There is a sting when the anesthetic is given. This does not numb the artery, so there will be brief, sharp pain as the catheter is inserted. There is a feeling of pressure as the catheter is advanced. As the dye is injected a burning sensation may occur. There is often tenderness and bruising at the site of the catheter insertion after the test. An enlarging mass, recurrent bleeding or significant pain in the extremity should signal the need for medical attention. |
| Why the test is performed | The extremities arteriogram helps identify and locate occlusions (closure of the vessel), stenoses (areas of narrowing) or sites of bleeding. The test is done for persons with symptoms of vascular disease in the extremity (acute or chronic) or after trauma. |
| Normal Values | The X-ray shows normal structures for the age of the patient. |
| What abnormal results mean | The X-ray may show blockage in the vessels caused by hardening of the arteries (arteriosclerosis), blood clots , diseases of the arteries, and aneurysms (sacs filled with blood that have formed because of an abnormal widening in the artery). Additional conditions under which the test may be performed: Deep venous thrombosisThromboangiitis obliterans Vasculitis Trauma Before surgery |
| What the risks are | Significant complications may occur. A reaction to the contrast medium can occur. There is some risk of the catheter damaging the artery or knocking loose a piece of a clot which can block the blood flow and cause tissue damage or even a stroke ; however, this is rare. A clot or bleeding at the puncture site may result in a partial blockage of the flow of blood to the leg. There is relatively low radiation exposure; however, most experts feel that the risk of X-rays is smaller than other risks we choose to take every day. Pregnant women and children are more sensitive to the risks of the X-ray . |
| Special considerations | Not applicable. |
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