This content has been prepared in accordance with the regulations of the Republic of Turkey Ministry of Health and medical ethics rules, for the purpose of protecting and informing public health. It does not contain any diagnosis, treatment guarantee, or referral. Please consult an authorized healthcare facility for the most accurate information.
Peripheral angiography is the imaging of vessels outside the heart (arteries and veins) using X-rays and contrast dye. This procedure is used for diagnosing peripheral artery disease, venous diseases, and vascular anomalies.
What is Peripheral Angiography?#
Peripheral angiography is an invasive imaging method used to evaluate the internal structure and blood flow of all vessels outside the heart.
Vessel Regions That Can Be Imaged:
| Region | Arteries | Clinical Condition |
|---|---|---|
| Lower Extremity | Iliac, femoral, popliteal, tibial | Leg pain, wounds |
| Upper Extremity | Subclavian, axillary, brachial | Arm pain, coldness |
| Abdomen | Aorta, mesenteric, renal | Kidney, intestine |
| Neck | Carotid, vertebral | Stroke risk |
Indications for Peripheral Angiography#
Lower Extremity (Leg) Angiography#
Indications:
- Leg pain while walking (claudication)
- Rest pain
- Non-healing foot wounds
- Diabetic foot
- Critical limb ischemia
- Acute arterial occlusion
Upper Extremity (Arm) Angiography#
Indications:
- Arm pain and coldness
- Subclavian steal syndrome
- Dialysis fistula evaluation
- Post-trauma evaluation
Carotid and Vertebral Angiography#
Indications:
- Transient ischemic attack (TIA)
- Stroke patients
- Carotid bruit
- Patients with stenosis on Doppler US
Renal (Kidney) Angiography#
Indications:
- Resistant hypertension
- Kidney function impairment
- Suspected renal artery stenosis
- Fibromuscular dysplasia
Mesenteric Angiography#
Indications:
- Chronic mesenteric ischemia
- Post-meal abdominal pain
- Weight loss
- Acute mesenteric ischemia
Pre-Procedure Preparation#
Tests and Evaluations#
- Blood tests: Kidney function (creatinine), coagulation tests
- Doppler Ultrasound: Initial assessment
- CT Angiography: Anatomical planning if needed
- Allergy history: Contrast allergy inquiry
- Medication list: Special attention to anticoagulants and antiplatelets
Patient Preparation#
- 6-8 hours fasting
- Metformin discontinuation (48 hours before)
- Anticoagulant adjustment
- Hydration (kidney protection)
- Consent form
How is Peripheral Angiography Performed?#
Access Routes#
Femoral Access (Groin):
- Most commonly used route
- Suitable for lower and upper extremity
- Antegrade or retrograde approach
Radial/Brachial Access (Wrist/Arm):
- Preferred for carotid angiography
- When femoral access is not suitable
Popliteal Access (Behind Knee):
- Special situations
- Retrograde tibial access
Procedure Steps#
- Local anesthesia: Applied to access site
- Vessel puncture: Artery entered with needle
- Sheath placement: For catheter passage
- Guidewire advancement: Toward target vessel
- Catheter placement: To area being imaged
- Contrast injection: Serial images taken
- DSA (Digital Subtraction): Bone image removed
- Hemostasis: Catheter removed, pressure applied
Procedure Duration#
- Diagnostic angiography: 30-60 minutes
- If treatment added: 1-3 hours
Angiography Findings#
Parameters Evaluated#
- Stenosis degree and length
- Occlusion location
- Collateral vessels
- Plaque morphology
- Flow dynamics
Stenosis Grading#
| Grade | Stenosis (%) | Clinical Significance |
|---|---|---|
| Mild | <50% | Follow-up |
| Moderate | 50-70% | Symptom-based |
| Severe | 70-99% | Treatment needed |
| Occluded | 100% | Urgent evaluation |
Treatment Options#
During or after angiography:
Same Session Treatment#
- Balloon angioplasty: Dilation of stenosis
- Stenting: Permanent support
- Atherectomy: Plaque removal
- Thrombolysis/Thrombectomy: Clot dissolution/removal
Next Steps#
- Medical treatment: Antiplatelet, statin, exercise
- Surgical bypass: For unsuitable lesions
- Hybrid approach: Surgical + interventional
Complications and Risks#
Peripheral angiography is a safe procedure, but rare complications include:
Access Site#
| Complication | Frequency | Management |
|---|---|---|
| Hematoma | 2-5% | Pressure, observation |
| Pseudoaneurysm | 0.5-1% | US-guided compression |
| AV fistula | <0.5% | Surgical/interventional |
| Retroperitoneal bleeding | <0.5% | Transfusion, surgery |
Systemic#
- Contrast nephropathy: Prevented with hydration
- Allergy: Reduced with premedication
- Embolization: Rare, treatable
- Dissection: Prevented with careful technique
Post-Procedure Care#
In Hospital#
- 4-6 hours bed rest (femoral)
- 2-4 hours (radial)
- Vital signs monitoring
- Access site check
- Continued hydration
After Discharge#
- No heavy lifting for 24-48 hours
- Keep access site dry
- Regular medication use
- Seek care if symptoms develop
Frequently Asked Questions#
What is peripheral angiography?
When is peripheral angiography performed?
Is peripheral angiography painful?
How long does peripheral angiography take?
When can I go home after peripheral angiography?
Appointment and Contact#
To schedule an appointment for peripheral angiography:
📍 Avrasya Hospital - Beştelsiz Mah. 101. Sokak No:107, Zeytinburnu, Istanbul
📞 Phone: +90 212 665 50 50 (Ext: 4012)
This content has been prepared by Assoc. Prof. Dr. Habib Çil for general informational purposes. Please consult a cardiology specialist for definitive diagnosis and treatment.
Related Peripheral Interventions#
Other services related to peripheral angiography:
- Carotid Stenosis - Neck vessel treatment
- Renal Artery Stenosis - Kidney vessel treatment
- Iliac Artery Treatment - Abdominal vessel treatment
- Dialysis Fistula Treatment - AV fistula interventions
- Peripheral Vascular Intervention - Leg vessel treatment