Diagnostic Cerebral and Peripheral Angiography

Abstract

Peripheral arterial disease is a debilitating and progressive disorder that affects millions of people worldwide (American College of Cardiology et al. Vasc Med 16(6):452–476, 2011; European Stroke et al. Eur Heart J 32(22):2851–2906, 2011). Advances in noninvasive modalities provide adequate methods for timely and accurate diagnosis. Despite these advancements, diagnostic angiography remains the gold standard for identification of vascular stenosis specifically if intervention is planned (Hirsch et al. J Am Coll Cardiol 47(6):1239–1312, 2006). As with any invasive procedures, complications occur with catheter-based contrast angiography. There is a 1 % incidence of vascular complications, most of which are local bleeding at the arterial access site (Kern The cardiac catheterization handbook. Elsevier Inc, California, 2011). Less common complications include adverse reactions to contrast media (Shehadi and Toniolo Radiology 137(2):299–302, 1980), contrast-induced nephropathy (Gleeson and Bulugahapitiya 2004), and vascular injury related to catheter manipulation. This chapter serves as a general introduction to the catheterization laboratory and diagnostic angiography. Imaging methods and standard equipment used in the endovascular suite will be described. The two most commonly used vascular access techniques, methods for selective angiography, and optimal views for arterial and venous angiography will also be discussed.