What is a pulmonary angiography?

Pulmonary angiography is a hospital-based diagnostic procedure that uses X-ray techniques to look at the inside of the blood vessels (pulmonary blood vessels) that supply blood to your lungs.
A pulmonary angiography detects problems in the blood flow of the pulmonary vessels. The results of the procedure are shown as a moving X-ray known as a pulmonary angiogram.
How is the pulmonary angiography procedure done?
- You will be asked to lay down on a table.
- The doctor administers a mild sedative through your veins to help you relax. An anesthetic is also injected into your arm or groin to numb it.
- The radiologist inserts a catheter (hollow, thin tube) through a blood vessel into your arm or groin.
- The catheter is directed into the right side of the heart to allow it to enter the pulmonary artery till it goes into the lung. The pulmonary artery is the artery that carries blood to your lungs.
- Next, a chemical known as contrast dye is injected into the catheter. The path of the dye till it reaches the lungs through the pulmonary artery is displayed on a monitor. It is shown in the form of X-ray images. The dye highlights any problem areas in the pulmonary artery and other pulmonary blood vessels.
After the procedure is completed, the doctor will check your pulse and blood pressure. Once the doctor confirms that they are normal, the catheter is removed.
Pressure is applied over the area (from where the catheter is removed) to control the bleeding. It can take 20-45 minutes.

SLIDESHOW
Heart Disease: Causes of a Heart Attack See SlideshowWhat happens after a pulmonary angiography?
- You may need to stay for a few hours or even overnight in the hospital.
- During your hospital stay, drink plenty of water after the procedure and after you go home.
- Keep the leg on the insertion side straight on the bed for 6 hours after the procedure.
- Take care of the insertion site as advised by your doctor.
Why is a pulmonary angiography done?
The test is used as a gold standard to detect blood clots (pulmonary embolism) in the lungs. It is usually done if other tests are not enough to diagnose the condition.
A pulmonary angiography may also be done to diagnose conditions that include:
- Stenosis (narrowing) of pulmonary blood vessels
- Artery and vein malformations in the lungs (abnormal connection of the artery and vein)
- Pulmonary artery aneurysm (bulging in the pulmonary artery)
- Problems in the blood vessels present by birth
- Pulmonary hypertension (high blood pressure in the arteries of the lungs)
- Foreign body in the blood vessels of the lung
A pulmonary angiography may also be done to deliver medicines into your lungs.
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How to prepare for a pulmonary angiography
Before the test is planned, your doctor will ask you
- If you are pregnant or breastfeeding.
- If you have any bleeding disorders.
- If you are on blood-thinning medications such as Aspirin (discontinuation for a few days before the procedure is necessary).
- If you have a history of allergy to the contrast material, shellfish, or iodine.
You must fast for six to eight hours before the procedure.
Remove all your jewelry at home before coming to the hospital.
All the risks of the procedure will be explained to you, and you will be asked to sign a consent form.
What are the risks of a pulmonary angiography?
The most common risk of a pulmonary angiography is the development of abnormal heart rhythm. This is a temporary condition that will be treated right away during the procedure.
Other risks include:
- Allergic reaction to the contrast dye
- Blood vessel injury (by the needle or catheter)
- Embolism (due to blood clot traveling to the lungs)
- Excessive bleeding at the site where the catheter is inserted
- Heart attack
- Stroke
- Hematoma (pooling of blood at the site of the needle puncture)
- Nerve injury
- Contrast dye-induced kidney damage
- Hemoptysis (coughing up blood)
- Respiratory failure
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