Renal arteriography
Renal arteriography is a special x-ray of the arteries of the kidneys.
How the Test is Performed
This test is done in the hospital or outpatient office by a radiologist usually assisted by a technician or other staff members. You will lie on an x-ray table.
Doctors often use an artery near the groin for the test. Occasionally, the doctor may use an artery in the wrist.
Your doctor will:
- Clean and shave the area.
- Apply a numbing medicine to the area.
- Place a needle into the artery.
- Pass a thin wire through the needle into the artery.
- Take out the needle.
- Insert a long, narrow, flexible tube called a catheter in its place.
The doctor directs the catheter into correct position using x-ray images of the body. An instrument called fluoroscope sends the images to a TV monitor, which the doctor can see.
The catheter is pushed ahead over the wire into the aorta (main blood vessel from the heart). It then enters the kidney artery. The test uses a special dye (called contrast) to help the arteries show on the x-ray. The blood vessels of the kidneys are not seen with ordinary x-rays. The dye flows through the catheter into the kidney artery.
X-ray images are taken as the dye moves through the blood vessels. Saline (sterile salt water) containing a blood thinner may also be sent through the catheter to keep blood in the area from clotting.
The catheter is removed after the x-rays are taken. A closure device is placed in the groin or pressure is applied to the area to stop the bleeding. You may be asked to keep your leg straight for 4 to 6 hours after the procedure.
How to Prepare for the Test
Tell your doctor if:
- You are pregnant
- You have ever had any bleeding problems
- You currently take blood thinners, including daily aspirin
- You ever had any allergic reactions, especially those related to x-ray contrast material or iodine substances
Allergic reactions
Allergic reactions are sensitivities to substances called allergens that come into contact with the skin, nose, eyes, respiratory tract, and gastroin...
Read Article Now Book Mark Article - You have ever been diagnosed with kidney failure or poorly functioning kidneys
You must sign a consent form. DO NOT eat or drink anything for 6 to 8 hours before the test. You will be given a hospital gown to wear and asked to remove all jewelry. You may be given a pain pill (sedative) before the procedure or IV sedatives during the procedure.
How the Test will Feel
You will lie flat on the x-ray table. There is usually a cushion, but it is not as comfortable as a bed. You may feel a sting when the anesthesia medicine is given. You may feel some pressure and discomfort as the catheter is positioned.
Some people feel a warm sensation when the dye is injected, but most people cannot feel it. You don't feel the catheter inside your body.
There may be slight tenderness and bruising at the site of the injection after the test.
Why the Test is Performed
Renal arteriography is often done after other tests are done first. These may include duplex ultrasound, CT abdomen, CT angiogram, MRI abdomen, or MRI angiogram. These tests may show the following problems.
Duplex ultrasound
A duplex ultrasound is a test to see how blood moves through your arteries and veins.
Read Article Now Book Mark Article- Abnormal widening of an artery, called an aneurysm
Aneurysm
An aneurysm is an abnormal widening or ballooning of a part of an artery due to weakness in the wall of the blood vessel.
Read Article Now Book Mark Article - Abnormal connections between veins and arteries (fistulas)
Fistulas
A fistula is an abnormal connection between two body parts, such as an organ or blood vessel and another structure. Fistulas are usually the result ...
Read Article Now Book Mark Article - Blood clot blocking an artery supplying the kidney
Blood clot blocking an artery supplying...
Acute arterial occlusion of the kidney is a sudden, severe blockage of the artery that supplies blood to the kidney.
Read Article Now Book Mark Article - Unexplained high blood pressure thought to be due to narrowing of the blood vessels of the kidneys
Narrowing of the blood vessels of the k...
Renovascular hypertension is high blood pressure due to narrowing of the arteries that carry blood to the kidneys. This condition is also called ren...
Read Article Now Book Mark Article - Benign tumors and cancers involving the kidneys
- Active bleeding from the kidney
If these tests show problems renal arteriography may be used to guide a treatment such as embolization or arterial stent placement.
Normal Results
Results may vary. Talk to your health care provider about the meaning of your specific test results.
What Abnormal Results Mean
Renal angiography may show the presence of tumors, narrowing of the artery or aneurysms (widening of the vein or artery), blood clots, fistulas, or bleeding in the kidney.
The test may also be done with the following conditions:
- Blockage of an artery by a blood clot
Blockage of an artery by a blood clot
Acute arterial occlusion of the kidney is a sudden, severe blockage of the artery that supplies blood to the kidney.
Read Article Now Book Mark Article - Renal artery stenosis
- Renal cell cancer
Renal cell cancer
Renal cell carcinoma is a type of kidney cancer that starts in the lining of very small tubes (tubules) in the kidney.
Read Article Now Book Mark Article - Angiomyolipomas (noncancerous tumors of the kidney)
Some of these problems can be treated with techniques done at the same time the arteriogram is performed.
- Angioplasty is a procedure to open a narrowed or blocked blood vessels that supply blood to your kidneys.
- A stent is a small, metal mesh tube that keeps the artery open. It may be placed to keep a narrowed artery open.
- Cancers and noncancerous tumors can be treated using a process called embolization. This involves using substances that block blood flow in order to kill or shrink the tumor. Sometimes, this is performed in combination with surgery.
- Bleeding can also be treated with embolization.
Risks
The procedure is generally safe. There may be some risks, such as:
- Allergic reaction to the dye (contrast medium)
- Arterial damage
- Damage to the artery or artery wall, which can lead to blood clots
- Kidney damage from damage to the artery or from the dye
There is low radiation exposure. Pregnant women and children are more sensitive to the risks related to x-rays.
Radiation exposure
Radiation sickness is illness and symptoms resulting from excessive exposure to ionizing radiation. There are two main types of radiation: nonionizin...
Read Article Now Book Mark ArticleConsiderations
The test should NOT be done if you are pregnant or have severe bleeding problems.
Magnetic resonance angiography (MRA) or CT angiography (CTA) can be done instead. MRA and CTA are noninvasive and can provide similar imaging of the kidney arteries, although they cannot be used for treatment.
Magnetic resonance angiography
Magnetic resonance angiography (MRA) is an MRI exam of the blood vessels. Unlike traditional angiography that involves placing a tube (catheter) int...
Read Article Now Book Mark ArticleReviewed By
Jason Levy, MD, FSIR, Northside Radiology Associates, Atlanta, GA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Azarbal AF, Mclafferty RB. Arteriography. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 27.
Duddalwar VA, Jadvar H, Palmer SL. Diagnostic kidney imaging. In: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Brenner and Rector's The Kidney. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 25.
Textor SC. Renovascular hypertension and ischemic nephropathy. In: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Brenner and Rector's The Kidney. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 47.