Angiography is a core diagnostic procedure in cardiology and interventional radiology. Its main goal is to provide high-resolution, real-time visualization of arterial and venous systems throughout the human body.

By introducing a specialized contrast agent into the blood vessels via a catheter, clinicians can observe dynamic blood flow, calculate pressure gradients, and pinpoint structural vessel abnormalities under fluoroscopic X-ray guidance.

1. Access Site Preparation: Cleaning and draping the wrist (radial) or groin (femoral) area under sterile conditions.
2. Local Anesthesia: Injecting local anesthetic near the access artery to numb the skin and underlying tissue.
3. Arterial Access: Inserting a needle into the artery using the Seldinger technique, followed by a flexible introducer sheath over a guidewire.
4. Catheter Advancement: Navigating a shaped diagnostic catheter through the vascular system to the target vessel under continuous fluoroscopy.
5. Selective Engagement and Dye Injection: Positioning the catheter tip into the vessel opening and injecting iodinated contrast dye.
6. Dynamic Image Acquisition: Taking high-speed X-ray image series to evaluate blood flow and structural integrity.
7. Catheter Removal and Hemostasis: Withdrawing the equipment and applying manual pressure, a radial compression band, or a femoral closure device to stop bleeding.

• Delivers high-resolution anatomical details of lumen structure and vascular flow.
• Allows diagnostic imaging and potential therapeutic intervention in a single session.
• Provides real-time pressure measurements inside heart chambers and blood vessels.
• Guides precise surgical or endovascular treatment planning.
• Maintains a low complication rate when performed using modern radial access techniques.

Immediate recovery involves two to six hours of supervised bed rest depending on whether radial or femoral vascular access was used. Minor local bruising and tenderness near the access point are normal and resolve within one to two weeks. Most patients resume normal daily routines within 48 hours, while strenuous physical activity, heavy lifting, and immersion bathing are restricted for five to seven days.

• Coronary artery disease (CAD) and acute coronary syndromes
• Peripheral artery disease (PAD) and lower limb ischemia
• Cerebral aneurysms, arteriovenous malformations, and ischemic stroke
• Renal artery stenosis and renovascular hypertension
• Aortic aneurysms and aortic dissection
• Pulmonary embolism and pulmonary hypertension
• Visceral arterial ischemia and internal gastrointestinal bleeding

1. Blood Tests: Checking serum creatinine, estimated glomerular filtration rate (eGFR), complete blood count, and coagulation times (PT/INR).
2. Fasting: Refraining from solid foods for 4 to 6 hours before the test; clear fluids are usually allowed up to 2 hours prior.
3. Medication Review: Adjusting antiplatelet drugs, blood thinners, or diabetes medications (such as metformin) under clinical direction.
4. Kidney Protection Hydration: Receiving intravenous saline fluids if pre-existing kidney dysfunction is noted.
5. Allergy Management: Administering premedication (corticosteroids and antihistamines) if a history of mild iodine allergy exists.

1. Common and Minor: Access site bruising (3-5%), local soreness, temporary warm flushing during contrast injection.
2. Uncommon: Contrast-induced acute kidney injury (1-2% in unselected patients), access site pseudoaneurysm (0.5-1%), allergic skin reactions like hives.
3. Rare and Serious: Retroperitoneal bleeding (<0.5%), major access site hematoma requiring transfusion (<0.5%), ischemic stroke (<0.2%), arterial vessel tear or dissection (<0.1%), severe anaphylaxis (<0.05%), death (<0.1%).

The patient journey begins with a clinical evaluation and blood tests to verify kidney function and blood clotting status. On the day of the procedure, local anesthesia and mild sedation are administered. A catheter is guided through an artery in the wrist or groin to the area of concern. Contrast dye is injected while X-ray images are captured. After catheter removal, hemostasis is achieved using compression or a vascular closure device. Patients are monitored in recovery for two to six hours before going home with activity guidelines and scheduled follow-up care.