The document is a presentation by Dr. Dheeraj Kumar on angiography, detailing its history, technological advancements, and applications in diagnosing and treating vascular conditions. Key historical milestones include Wilhelm Roentgen's discovery of x-rays and Egaz Moniz's first cerebral angiography. The future of angiography is trending towards enhanced imaging technologies and personalized medicine.

1. Angiography
Presenter: Dr. Dheeraj Kumar
MRIT, Ph.D. (Radiology and Imaging)
Assistant Professor
Medical Radiology and Imaging Technology
School of Health Sciences, CSJM University, Kanpur
Friday, 13 October 2023 Angiography By- Dr. Dheeraj Kumar 1

2. Introduction
• Welcome to the world of Angiography.
• Angiography is a crucial diagnostic tool
within Radiology.
• It allows us to visualize blood vessels,
aiding in the diagnosis and treatment of
various medical conditions.
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3. Definition
Angiography: What is it?
• Angiography is a medical imaging
technique used to visualize the blood
vessels in the body.
• This procedure is both diagnostic and
interventional, helping us see and treat
vascular conditions.
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4. Historical Milestones
Step back in time to discover the roots of Angiography.
• Important moments in the history of Angiography include:
• 1896: Wilhelm Roentgen's discovery of X-rays - The foundation of medical
imaging.
• 1927: Egas Moniz performs the first cerebral angiography - A groundbreaking
application of X-ray technology.
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5. Pioneering Scientists
Visionaries who shaped the field of
Angiography include:
• Wilhelm Roentgen:
• Discovered X-rays in 1896, leading to the
foundation of medical imaging
techniques.
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6. Egas Moniz
• Performed the first cerebral
angiography in 1927,
pioneering the use of X-rays
to visualize blood vessels.
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7. Sven-Ivar Seldinger
Introduced the Seldinger
technique in 1953, a
minimally invasive method
for accessing blood vessels,
revolutionizing angiography
procedures.
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8. Early Beginnings
• The birth of Angiography:
• Wilhelm Roentgen's discovery of X-rays in 1896 laid the foundation for the
development of Angiography.
• The ability to see inside the body without surgery was a revolutionary
breakthrough.
• Egas Moniz's 1927 cerebral angiography marked the first practical application
of X-rays to visualize blood vessels in a patient's brain.
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9. Advancements in Angiography
• The journey of Angiography through time:
• 1953: Sven-Ivar Seldinger introduced the Seldinger technique.
• This technique involved a guide wire and catheter, allowing for a safer and more
controlled approach to vascular access.
• 1960s: Development of digital subtraction angiography (DSA).
• DSA was a significant leap forward, providing real-time imaging with contrast
subtraction, leading to improved visualization of vascular structures.
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10. Digital Subtraction Angiography (DSA)
• DSA - A game-changer in Angiography:
• DSA is a technique that combines X-ray technology with computer processing to
provide real-time subtraction of images.
• It involves taking an initial image with contrast, then a subsequent image without
contrast. The software subtracts the two images, leaving only the blood vessels.
• DSA greatly improved the quality and accuracy of angiographic imaging, enabling
better diagnosis and treatment planning.
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11. In image A, Digital subtraction angiography (DSA) shows a ruptured wide-necked left internal carotid artery (ICA) aneurysm
in a 69-year-old woman with subarachnoid hemorrhage. A pseudoaneurysm is noted at the ruptured aneurysm's fundus. Image
B displays the same patient after the deployment of a 4 ϫ 15-mm Neuroform2 stent in the ICA, with the aneurysm embolized
and no contrast material inside it. In Image C, an unsubtracted angiography view shows the stent in the ICA and the coils in the
aneurysm. Image D is another unsubtracted view, displaying the markers of the stent and the coils. Images E and F represent a
17-month follow-up DSA, showing the left ICA with the aneurysm no longer visible and all branches patent.
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12. Catheter Angiography
• Advancements in catheter technology:
• Catheter angiography involves inserting a catheter into a blood vessel, often through
the Seldinger technique.
• This allows for minimally invasive and highly precise angiographic procedures.
• Catheter angiography plays a crucial role in both diagnosis and treatment of vascular
conditions, including angioplasty, stent placement, and embolization procedures.
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13. 1. Initial catheter coronary angiogram image. (A) Diffuse dilatation of the left main coronary artery (5 mm) with a giant aneurysm (9.2
mm) at the proximal left anterior descending segment (red arrows). (B) Right coronary artery with an aneurysm (5 mm) at the proximal
segment with subtotal occlusion of the mid and distal segments (red arrows).
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14. Magnetic Resonance Angiography (MRA)
• A non-invasive alternative:
• Magnetic Resonance Angiography (MRA) is a non-
invasive imaging technique that uses magnetic
fields and radio waves.
• MRA provides high-resolution images of blood
vessels without ionizing radiation, making it a safer
option for some patients.
• It's particularly useful for visualizing vascular
structures in the brain, neck, and other parts of the
body.
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15. Computed Tomography Angiography
(CTA)
The power of CT scanning:
• Computed Tomography Angiography (CTA) is
an advanced imaging technique that combines
CT scanning with contrast injection.
• It produces high-resolution 3D images of blood
vessels, allowing for the detection and
characterization of vascular diseases.
• CTA is known for its speed and accuracy in
diagnosing conditions in various body parts,
including the heart and the extremities.
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16. Interventional Angiography
• Beyond diagnosis:
• Angiography isn't limited to diagnosis; it
also plays a pivotal role in minimally
invasive treatments.
• Interventional angiography involves
procedures like angioplasty, stent placement,
and embolization, which can treat conditions
such as arterial blockages, aneurysms, and
abnormal blood vessel growth.
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17. Angiography Applications
Where Angiography plays a vital role:
• Cardiac Angiography: Used to diagnose and treat heart conditions, including
coronary artery disease and valvular issues.
• Cerebral Angiography: Vital for examining the blood vessels in the brain, often used
in cases of stroke or aneurysms.
• Peripheral Angiography: Focuses on the blood vessels in the extremities, useful for
diagnosing peripheral artery disease (PAD) and other vascular issues.
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19. Risks and Safety
Understanding the potential risks:
• While angiography is a valuable tool, it's not
without risks. It exposes patients to ionizing
radiation, and contrast dye can have side
effects.
• Radiology professionals are trained to
minimize radiation exposure to the patient
while obtaining high-quality images.
• Medical teams take precautions to address
contrast dye allergies and renal issues.
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20. Future Trends
The future of Angiography:
• Advancements in imaging technology, such as improved detectors and imaging
algorithms, will continue to enhance the accuracy and speed of angiography.
• Personalized medicine is an emerging trend, tailoring angiographic approaches to
individual patients.
• Precision interventions will become increasingly common, thanks to improved
imaging and minimally invasive techniques.
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21. Conclusion
Angiography's historical journey:
• We've seen how angiography has evolved from the discovery of X-rays to the
development of advanced techniques like MRA and CTA.
• Its role in both diagnosis and treatment is crucial to modern medicine.
• The field of angiography is dynamic, with ongoing advancements and
expanding applications.
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22. References
1. Roentgen, W. C. (1896). A New Kind of Rays: A Preliminary Communication. Nature, 53(1369), 274-
276.
2. Moniz, E. (1927). L’Encéphalographie Arterielle: Son Importance dans les Tumeurs Cérébrales.
Revue de Neurologie, 33, 1106-1108.
3. Seldinger, S. I. (1953). Catheter Replacement of the Needle in Percutaneous Arteriography: A New
Technique. Acta Radiologica, 39(5), 368-376.
4. Prince, M. R., & Brown, M. A. (1991). Magnetic Resonance Angiography: Current Status and Future
Directions. Journal of Magnetic Resonance Imaging, 1(1), 97-104.
5. Huda, W., & Scalzetti, E. M. (2006). Doses to Patients Undergoing Angiographic and Interventional
Radiology Procedures: The Impact of New Technologies. Radiology, 240(3), 625-630.
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23. Any Questions?
Open the floor for questions and discussions:
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24. Thank You
Thank the dear students for their attention
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