Catheter-directed angiography is still the ‘gold standard’ in vascular imaging, but it is invasive (intra-arterial instrumentation) and therefore often reserved for those likely to require a simultaneous therapeutic intervention. Any stenosis identified (taken in at least two planes) is ‘percentage’ quantified according to the degree of luminal narrowing (50%, 75%, 90%, 100% [total occlusion]).

The Angiography Suite

This is a purpose-built room for diagnostic and therapeutic intervention often located in the radiology department, although in modern vascular practice the suite often doubles as an operating room (hybrid suite) located within the main theatre complex. The room must adhere to national radiation safety standards.

Personnel

• Operator (vascular surgeon and/or radiologist).
  
• Nurse assistant (scrub nurse/operating department practitioner).
  
• Radiology technician (radiographer).
  
• Anaesthetist (if anaesthesia or sedation required).

Equipment

• Fluoroscopy/X-ray equipment (with monitors).
  
• Angiography-compatible table.
  
• Power injector.
  
• Consumables (sheaths, wires, catheters, devices, etc.).
  
• Full anaesthetic equipment.

Basic Steps in Angiography

1. Access (vessel for instrumentation).
   
2. Travel (to vessel of interest).
   
3. Imaging.
   
4. Intervention.
   
5. Re-imaging.
   
6. Removal of access and haemostasis.

Radiation Safety

Radiation exposure decreases proportionately by the square of the distance from the source.