Treatments

An angiogram, also called an arteriogram, is an X-ray image of the blood vessels. It is performed to evaluate various vascular conditions, such as an aneurysm, stenosis or blockages.
A renal angiogram is an angiogram of the blood vessels of the kidneys. A renal angiogram may be used to assess the blood flow to the kidneys.
Fluoroscopy is often used during a renal arteriogram. Fluoroscopy is the study of moving body structures similar to an X-ray “movie.” A continuous X-ray beam is passed through the body part being examined, and is transmitted to a TV-like monitor so that the body part and its motion can be seen in detail.

In order to obtain an X-ray image of a blood vessel, an intravenous (IV) or intra-arterial (IA) access is necessary so that contrast, also known as X-ray dye, can be injected into the body’s circulatory system. This contrast dye causes the blood vessels to appear opaque on the X-ray image, thus allowing the physician to better visualize the structure of the vessel(s) under examination.

Many arteries can be examined by an angiogram, including the arterial systems of the legs, kidneys, brain, and heart.

For a renal angiogram, arterial access may be obtained through a large artery such as the femoral artery in the groin. Once access is obtained, the catheter is advanced to the renal artery, contrast is injected, and a series of X-ray pictures is made. These X-ray images show the arterial, venous, and capillary blood vessel structures and blood flow in the kidneys.

Other related procedures that may be used to diagnose kidney problems include kidney, ureters, and bladder (KUB) X-ray, computed tomography (CT scan) of the kidneys, intravenous pyelogram, kidney biopsy, kidney scan, kidney ultrasound, magnetic resonance imaging (MRI), and renal venogram. Please see these procedures for additional information.

A renal angiogram may be performed to detect abnormalities of the blood vessels of the kidneys. Such abnormalities may include, but are not limited to, the following:

• Aneurysms
• Stenosis or vasospasm (spasm of the blood vessel)
• Arteriovenous malformation (an abnormal connection between the arteries and veins)
• Thrombosis (a blood clot within a blood vessel) or occlusion (blockage of a blood vessel)
• Renovascular hypertension (systemic high blood pressure caused when the renal artery is narrowed)

Other conditions that may be detected by a renal angiogram include tumours, hemorrhage (bleeding), complications of kidney transplantation, and the invasion of a tumour into the blood vessels. An angiogram may be used to deliver medications directly into the tissue or organ needing treatment, such as the administration of a clotting medication to a bleeding site or cancer medication into a tumour.

Renal angiograms are less frequently use with CT and MRI scans being more commonly used for diagnosing these conditions. Renal angiogram may also be recommended after a previous procedure, such as a CT scan, indicates the need for further information.

There may be other reasons for your doctor to recommend a renal angiogram.

You may want to ask your doctor about the amount of radiation used during the procedure and the risks related to your particular situation. It is a good idea to keep a record of your past history of radiation exposure, such as previous scans and other types of X-rays, so that you can inform your doctor. Risks associated with radiation exposure may be related to the cumulative number of X-ray examinations and/or treatments over a long period of time.

If you are pregnant or suspect that you may be pregnant, you should notify your health care provider. Radiation exposure during pregnancy may lead to birth defects.

There is a risk for allergic reaction to the contrast. Patients who are allergic to or sensitive to medications, contrast dye, or iodine should notify their doctor. Also, patients with kidney failure or other kidney problems should notify their doctor as contrast can worsen existing kidney disease.

Because the procedure involves the blood vessels and blood flow of the kidneys, there is a small risk for complications involving the kidneys. These complications may include, but are not limited to, the following:

• Hemorrhage due to puncture of a blood vessel
• Injury to nerves
• Thrombus. A clot in the blood vessel
• Hematoma. An area of swelling caused by a collection of blood
• Infection
• Transient kidney failure
• Damage to artery or arterial wall, which can lead to blood clots

There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your doctor prior to the procedure.
Certain factors or conditions may interfere with the accuracy of a renal angiogram. These factors include, but are not limited to, the following:

• Remaining contrast substances from recent contrast studies, such as a barium enema
• Gas or stool in the intestines