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Renal Angiogram and Angioplasty
Posted on Mar 04, 2016
A renal angiogram or renal arteriogram is an imaging study of the arteries which supply the kidneys with blood. This type of imaging study is ordered when a patient is experiencing kidney problems or is believed to be at risk of a kidney disorder. It takes place in a hospital or clinic with angiography facilities, and the length of time required for the procedure varies. Patients are usually encouraged to arrange for a ride home after the procedure, as they may feel groggy.

There are a number of reasons to request a renal angiogram. A doctor may suspect that the veins are stenosed or blocked, or that a ballooning known as an aneurysm is occurring. Tumours could be pressing on the blood supply and interrupting it, and other kidney problems might be leading to alterations in the vessels which supply the kidneys with blood. A renal angiogram may also be ordered if a patient has hypertension, to learn more about the cause of the high blood pressure.

During the angiography procedure, the patient lies on a table while a catheter is inserted through the groin to access the renal artery so that contrast material can be injected. Images are taken with a fluoroscopy machine for real time imaging, or with an X-ray for still images. The patient is usually given medications which will help him or her stay calm and still during the procedure, especially if the patient has a history of discomfort and restlessness during medical procedures.

The contrast dye will highlight the blood vessels on the renal angiogram. In a procedure known as digital subtraction angiography, a computer removes other structures in the image such as bones so that the network of blood vessels can be very clearly seen. Examining the renal angiogram, a doctor can identify areas of abnormality which indicate the need for intervention, such as stenting to open an occluded renal artery, or surgery to address a tumour on the kidneys.

A renal angiogram can be contraindicated for some patients. Patients with blood which is slow to clot can be in danger because the procedure causes bleeding and there is also a risk of rupturing a vessel. For pregnant women, any procedure requiring radiation is not recommended unless it is absolutely necessary because radiation can hurt the developing foetus. People with allergies may also be at risk during a renal angiogram, because they may react to the contrast agent. Patients should be sure that doctors know their full clinical history before consenting to a procedure.

What is angioplasty?

Angioplasty is a procedure that is performed for widening the arteries that become constricted due to plaque deposits. Atherosclerosis is a medical condition wherein the arteries become hard and constricted due to the accumulation of plaque deposits in the arterial walls. Problems arise when the blood supply becomes restricted due to narrowing of the arteries. For instance, blockage of coronary arteries (arteries that supply oxygenated blood to the heart) gives rise to chest pain (angina) and various distressing symptoms. Angioplasty is a surgical procedure that is recommended when drug therapy doesn't help in improving the blood flow.

The Procedure

  • This is a percutaneous surgery intervention (PCI) that helps in restoring the blood flow to the heart in case of coronary artery disease. This surgery is also known as percutaneous transluminal coronary angioplasty (PTCA).
  • The patient is administered local anaesthesia so that he/she doesn't feel pain during the procedure.
  • To locate the blockage, a catheter is inserted into an artery, usually in the groin before it is threaded to the coronary arteries. A special dye that can be seen on X-rays is injected into the coronary arteries. This helps the doctors determine the site of blockage within the artery.
  • An empty balloon catheter is inserted within the blocked artery. It is guided into the aorta with the help of the guide wire.
  • When the catheter is inflated, it compresses the plaque in the arterial walls, thereby creating more space for the blood to flow.
  • The balloon is deflated and removed. In some cases, a collapsed stent or a tiny mesh tube is inserted so that the artery remains open. The stent helps in preventing closure of an artery.
  • A contrast dye is inserted again and any remaining blockages are checked.

The risks involved

The risks associated with angioplasty include bleeding at the site of the catheter insertion or damage to the blood vessel. In some cases, blood clots might form within the stent. In rare cases, the patient might suffer from cardiac arrhythmia or dysrhythmia, stroke, or heart attack.

The Uses

As we already know, angioplasty is a procedure that helps in widening blocked arteries in the body. Other common uses include:
Written by : Lazoi Team
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