Introduction
People often confuse the terms Pulmonary Angiography(PA) and pulmonary angiogram. Although used interchangeably, these two terms are very different in their meaning.
PA refers to the important diagnostic procedure used in the field of medicine to detect pulmonary artery abnormalities. Moreover, PA plays a critical role in identifying abnormalities, assessing blood flow, and guiding the treatment. It does so by providing detailed images of the blood vessels in the lungs.
On the other hand, pulmonary angiogram refers to the X-Ray images obtained during the PA procedure.
Therefore let’s explore the procedure of PA; and what part it plays in the patient’s treatment.
Understanding Pulmonary Angiography
Pulmonary angiography plays a significant role in diagnostics. PA is an effective procedure for detecting pulmonary artery abnormalities and treating them timely.
Don’t know what PA is? So let’s understand the basics of PA through simple bullet points:
- Pulmonary angiography is a diagnostic procedure and a medical imaging technique.
- Its origin dates back to the time of the mid-20th century.
- Moreover, it detects abnormalities in the pulmonary arteries. Pulmonary arteries are the blood vessels that carry deoxygenated blood from the heart to the lungs.
- In this process, a catheter is inserted via a vessel in the groin, arms, or legs to detect any constriction in the arteries. Moreover, they make use of various imaging models to monitor the process.
- Furthermore, any constriction or narrowing in the arteries can be easily detected via PA.
- It is a simple procedure that requires around 1 hour to complete.
- Moreover, PA can detect a range of pulmonary artery abnormalities like; Pulmonary Vascular Congestions, Saddle Pulmonary Embolism, etc.
- However, many risk factors link with this diagnostic technique, like; allergic reactions, bleeding, etc.
What Can Pulmonary Angiography Diagnose?
With a simple overview of Pulmonary Angiography, let’s see what issues it can detect:
- Pulmonary Emboli (PE): the blood clots in the lungs.
- Congenital Abnormalities: a birth defect that narrows the pulmonary artery.
- AV Malformations of the Lungs: The disrupted connections between arteries and veins.
- Pulmonary Artery Aneurysms: a bulging of the pulmonary artery.
- Pulmonary Hypertension: high blood pressure in the pulmonary artery.
How to Prepare for Pulmonary Angiogram?
Are you suffering from lung artery narrowing, and the physician has recommended a PA? You are worried about what to do. How to get ready before a PA? Don’t worry, as this section will guide you to the pre-test preparations that you need to follow:
- Do not eat anything six hours before the procedure.
- Do not drink clear fluid; two hours prior to the test procedure.
- Stop taking certain medications like those for diabetes or blood thinners. For instance, if you take SGLT2 for diabetes, stop taking them three days before the tests.
- Be relaxed and take off any jewelry that you are wearing. Moreover, wear a hospital suit.
How is the Test Performed?
Now, you have known all the prerequisites. So, let’s make you aware of what’s actually going to happen to you during a Pulmonary Angiography session:
- Firstly, the anesthesiologist will administer a local anesthetic to numb the area where the physician will insert the catheter. Usually, it’s the groin area; or a vein of the arm or leg where the physician inserts the catheter.
- Secondly, they will insert the catheter gently up the vein. It will move through the heart and then the pulmonary artery in the lungs.
- Thirdly, they will insert a dye into your veins. However, you will feel a warm flush.
- As the dye flows through the blood vessels, live imaging will trace any narrowing or blockage. The imaging models usually used are X-rays.
- Lastly, they will remove the catheter after having pulmonary angiograms. Then they will apply pressure to the catheter’s point of insertion to control blood flow.
Use of Contrast Dyes:
Contrast dyes are essential for PA. It is due to their ability to improve the visibility of the pulmonary vasculature during the imaging process. They inject these compounds into the bloodstream to enhance blood vessels. It increases the quality of the generated images. Furthermore, the PA procedure makes use of Iodine-based contrast dyes. They offer high radiodensity, which increases the visibility of arteries on X-ray or CT images.
When administered, contrast dyes circulate through the bloodstream. They fill the pulmonary arteries selectively. It allows for clear differentiation of the vessels from surrounding tissues.
Pulmonary Angiography: After Process Scenario.
What happens next? After going through the procedure of PA, the following things need consideration:
- You will have to wait for recovery for a few hours. Don’t get up too quickly.
- If the catheter’s insertion point is the groin, keep your legs straight for some time. Moreover, the clinical staff will continuously monitor your blood pressure, breathing rate, and pulse.
- Furthermore, the physician might allow you to go how the same day. However, you will not be able to drive. Therefore, it is better to arrange transport prior.
After undergoing the process of PA, take care of some significant factors:
- Drink plenty of water to flush out the dye present in your vessels.
- Avoid heavy exercises and move slowly. Continue this for at least a few days.
- Although it feels cozy, avoid a hot shower or bath for a few days.
- Check the site of the catheter’s insertion regularly to see any bleeding, swelling, or pain.
- If; you observe any redness, swelling, bleeding, fever, pain, or numbness in your leg and arms, seek your doctor.
What are the Imaging Modalities for Pulmonary Angiography?
Physicians can perform Pulmonary angiography using various imaging modalities, each with its own advantages and limitations:
- X-ray angiography provides real-time imaging but has a lower resolution than other modalities.
- CT angiography offers three-dimensional images and widely used due to its high accuracy.
- MRI angiography provides excellent soft tissue visualization and is useful for certain patients.
The decision to choose the correct imaging model depends on various factors. These include the patient’s condition, patient characteristics, and available resources.
Interpretation of PA Images:
Interpreting the pulmonary angiogram requires a deep knowledge of the anatomy and physiology of the pulmonary vasculature. Both radiologists and physicians look for specific details like filing defects, vessel narrowing, blood flow abnormalities, etc. These interpretations require expertise and teamwork between the radiologists and the clinicians.
Benefits:
PA offers numerous benefits as a diagnostic tool:
- Provides detailed images that guide the correct treatment method.
- Enables interventions in various cases.
- It helps to select the most accurate treatment method.
- Direct visualization of the pulmonary vasculature.
- Monitoring of high blood pressure.
Risk Factors:
Every benefit comes with certain risks. Similar is the case with PA. Although the PA risks are mild, there are no reported serious complications. The common risk observed is bruising and swelling on the catheter’s insertion point.
Some other risk factors include:
- Allergic reactions to the medications or X-Ray dyes after the procedure.
- Infection.
- Bleeding.
- Arrhythmias (irregular heartbeats).
- Lung vessel injuries.
- Reduced functions of the kidneys.
The patient gets exposure to X-Ray radiation. However, the benefits of Pulmonary Angiography are more than the risks associated with X-Ray radiation. You need extra precautions during the pregnancy. So, consult your physician about conducting the X-ray imaging test.
Minimizing Risk Factors:
Every cloud has a silver lining. The same is true for the risk factors associated with the PA. Here are a few tips for managing or reducing the risk factors:
- Careful patient selection.
- Pre-procedure evaluation of the patient. It includes conducting a brief medical history, allergies, renal functions, etc.
- Conduct proper screening of patients before administering the contrast dye.
- Adhere to radiation safety protocols to minimize the risk factors.
- Manage allergies and anaphylaxis immediately and effectively.
Conclusion;
To conclude, Pulmonary Angiography is a powerful diagnostic tool for pulmonary artery imaging. It helps to monitor the narrowing of the pulmonary arteries in the lungs. Pulmonary arteries are vessels carrying deoxygenated blood from the heart to the lungs. Furthermore, the imaging test most commonly used is the X-Ray technique. It allows for clear imaging with the help of contrast dyes. These dyes help to distinguish between the arteries and the surrounding tissues.
The procedure of Pulmonary Angiography is simple and takes less than an hour. It includes numbing the area for administering catheters. Then, a catheter is inserted via a vein in the groin, arms, or legs which reaches the pulmonary artery via the heart. The physician inserts a contrast dye for clear imaging of arteries. Moreover, this whole process is carried out with X-Ray imaging which provides clarity and aids in after-process monitoring.
Many risk factors are associated with PA, like; allergies, infections, bleeding, etc. However, these can be reduced via pre-procedure evaluations of the patient and prescribing the correct dyes and imaging process.
If you want to consult a pulmonary doctor, book an appointment with us and get treated.
