Arteriografi

Arteriografi is a radiographic examination used to visualize the arterial system by injecting contrast material and imaging with X-ray fluoroscopy or cross-sectional imaging. It provides detailed information about arterial anatomy and pathology and can be diagnostic or guide endovascular treatment. Non-invasive alternatives include CT angiography (CTA) and MR angiography (MRA), which image vessels with CT or MRI using contrast in a less invasive manner.

Techniques: Conventional catheter-based arteriography involves arterial access (commonly femoral or radial), selective catheterization to the region of interest, and intra-arterial iodinated contrast injection with fluoroscopic imaging. Digital subtraction angiography (DSA) enhances visualization by removing non-vascular structures. CTA uses intravenous contrast with CT to produce arterial datasets, while MRA uses MRI with gadolinium-based contrast or non-contrast sequences, often with time-resolved imaging.

Indications: Evaluation of arterial occlusion, stenosis, aneurysm, dissection, or arteriovenous malformations; preoperative vascular mapping; planning and guidance of endovascular therapies; stroke or limb-threatening vascular compromise; peripheral arterial disease.

Procedure and risks: The procedure is invasive and carries risks such as contrast reactions, contrast-induced nephropathy, radiation exposure, vascular injury, hematoma at access site, infection, and, in cerebral studies, rare neurologic complications. The choice between catheter-based arteriography and non-invasive modalities depends on diagnostic needs and patient factors.

Preparation and aftercare: Renal function assessment and hydration are typical pre-procedure steps; fasting and medication adjustments may be advised. After the procedure, the access site is compressed, and patients are monitored for complication signs.

History: Early cerebral arteriography emerged in the 1920s, with modern DSAs developed in the late 20th century; CTA and MRA became common non-invasive options thereafter.