|
Mesenteric angiography
Definition
Mesenteric angiography is a test used to examine the blood vessels that supply the small and large intestines.
Angiography is an imaging test that uses x-rays and a special dye to see inside the arteries. Arteries are blood vessels that carry blood away from the heart.
Alternative Names
Abdominal arteriogram; Arteriogram - abdomen; Mesenteric angiogram
How the Test is Performed
This test uses x-rays and a special dye called contrast to make blood vessels show up on the images.
This test is usually done in the radiology area in a hospital. You will lie on an x-ray table. You may ask for a sedative if you are anxious about the test.
- During the test, you will be hooked up to various devices so that your blood pressure, heart rate, and breathing can be monitored.
- The health care provider will shave and clean the groin area over an artery. A numbing medicine (anesthetic) is injected into the skin over an artery and a needle is inserted into an artery.
- A thin flexible tube called a catheter is passed through the needle, into the artery, and up through the main vessels of the belly area until it is properly placed into a mesenteric artery. The doctor can see live images of the area on a TV-like monitor, and uses the x-rays as a guide.
- Contrast dye is injected through this tube to determine any defects of the blood vessels. X-ray images are taken of the artery.
Certain treatments can be done during this procedure. These items are passed through the catheter to the area in the artery that needs treatment. These include:
- Dissolving a blood clot with medicine
- Opening a partially blocked artery with a balloon
- Placing a small tube called a stent into an artery to help hold it open
After the x-rays or treatments are finished, the catheter is removed. Pressure is immediately applied to the puncture site for 20-45 minutes to stop the bleeding. After that time the area is checked and a tight bandage is applied. The leg is usually kept straight for another 6 hours after the procedure.
How to Prepare for the Test
You should not eat or drink anything for 6 - 8 hours before the test.
You will be asked to wear a hospital gown and sign a consent form for the procedure. Remove jewelry from the area being imaged.
Tell your health care provider:
- If you are pregnant
- If you have ever had any allergic reactions to x-ray contrast material or iodine substances
- If you are allergic to any medications
- Which medications you are taking (including any herbal preparations)
- If you have ever had any bleeding problems
How the Test Will Feel
The x-ray table is hard and cold, but you may ask for a blanket or pillow.
You may feel a brief sting when the numbing medication (anesthetic) is given. You will feel a brief sharp pain as the catheter is inserted into the artery, and some pressure as it is moved into place. Usually you will only feel a sensation of pressure in the groin area.
As the dye is injected, you will feel a warm, flushing sensation. You may have tenderness and bruising at the site of the catheter insertion after the test.
Why the Test is Performed
This test is done:
- When someone has symptoms of a narrowed or blocked blood vessel in the intestines
- To find the source of bleeding in the gastrointestinal tract
- To find the cause of ongoing abdominal pain and weight loss when no cause can be identified
- When other studies do not provide enough information about abnormal growths along the intestinal tract
- To look at blood vessel damage after an abdominal injury
A mesenteric angiogram may be performed after more sensitive nuclear medicine scans have identified active bleeding. The radiologist can then pinpoint and treat the source.
See: Endovascular embolization
Normal Results
Results are considered normal if the arteries being examined are normal in appearance.
What Abnormal Results Mean
A common abnormal finding is narrowing and hardening of the arteries that supply the large and small intestine (mesenteric ischemia). The problem occurs when fatty material (plaque) builds up on the walls of your arteries.
Bleeding in the small and large intestine is another abnormal finding. It may be caused by:
- Angiodysplasia of the colon
- Blood vessel rupture from injury
Other abnormal results may be due to:
- Blood clots
- Cirrhosis
- Tumors
Risks
There is some risk of the catheter damaging the artery or knocking loose a piece of the artery wall, which can reduce or block blood flow and lead to tissue death. This is a rare complication.
Other risks include:
- Allergic reaction to the contrast dye
- Blood clot that travels to the lungs
- Damage to the blood vessel where the needle and catheter are inserted
- Excessive bleeding or a blood clot where the catheter is inserted, which can reduce blood flow to the leg
- Heart attack or stroke
- Hematoma -- a collection of blood at the site of the needle puncture
- Infection
- Injury to the nerves at the needle puncture site
- Kidney damage from the dye
References
Jackson JE, Allison DJ, Meaney J. Angiography: Principles, techniques (including CTA and MRA) and complications. In: Grainger RC, Allison D, Dixon AK, eds. Radiology: A Textbook of Medical Imaging. 5th ed. New York, NY: Churchill Livingstone; 2008:chap 6.
Morgan RA, Belli A-M, Munneke G. Peripheral vascular disease. In: Grainger RC, Allison D, Dixon AK, eds. Radiology: A Textbook of Medical Imaging. 5th ed. New York, NY: Churchill Livingstone; 2008:chap 28.
Reviewed By: David C. Dugdale, III, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by Shabir Bhimji, MD, PhD, Specializing in General Surgery, Cardiothoracic and Vascular Surgery, Midland, TX. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
