Management of Arterial Angiography
Once arterial disease is diagnosed, its management depends on what type of pathology is involved and whether the condition is stable vs. warranting urgent treatment.
- CT angiography: Is used to follow aortic aneurysms and once a crucial threshold is breached (usually > 5.5 cm diameter or an acceleration of expansion) the risk of imminent rupture outweighs any risks to surgical intervention or grafting insertions via arteriography, and such intervention is planned and carried out.
- Atherosclerosis: Is treated by minimizing the aggravating factors: weight management, antihypertensive medications, statin drugs for cholesterol/triglyceride elevations, smoking cessation, and supervised physical exercise.
- Ischemia: In distal organs due to emboli are invasively addressed radiographically using arteriography. An invasive interventional radiologist or vascular interventionist can thread a catheter to the involved area under fluoroscopic guidance to destroy or remove the blockage, reestablishing blood flow to the organ in danger of ischemia.
- Treatment of arterial thrombus formation: is via anticoagulation therapy for several months accompanied by imaging the area(s) for resolution or extension.
- Congenital arteriovenous fistulas: Which allow high-pressure arterial flow to enter the low-pressure venous flow, is corrected surgically to prevent the complications of varicosities, nerve compression, and deep vein thrombosis associated with this abnormality. Dialysis patients, for whom an AV fistula is created for therapeutic reasons, must be assessed for the same complications a spontaneous or congenital AV fistula can produce.
- Carotid endarterectomy or stenting: Is used to treat carotid stenosis once criteria are reached (per cent of blockage or appearance of symptoms such as TIAs or strokes). Arteriography plays an important part in determining the treatment threshold.