CT UPEER LIMB ANGIOGRAPHY

A CT Upper Limb Angiography is a specialized, minimally invasive diagnostic imaging test that provides your doctor with a highly detailed look at the blood vessels in your arms. Its primary purpose is to visualize the arteries in your shoulders, arms, forearms, and hands using advanced Computed Tomography (CT) technology and a special contrast dye. This powerful imaging technique is crucial for accurately diagnosing and evaluating a range of vascular conditions affecting the upper extremities, from blockages and injuries to complex anatomical issues. At Cadabam's diagnostics, we use state-of-the-art equipment to ensure the highest quality images for a precise diagnosis, guiding your doctor toward the most effective treatment plan.

What is a CT Upper Limb Angiography?

A CT Upper Limb Angiography combines two powerful technologies to create exceptionally clear pictures of your arteries. First, a sophisticated CT scanner takes a series of X-ray images from multiple angles around your arm. A computer then processes these images to create detailed, cross-sectional "slices." To make the arteries stand out, a safe, iodine-based contrast material is injected into a vein, typically in your arm. This dye travels through your bloodstream, highlighting the arteries so they appear bright white on the scan images.

Unlike a standard X-ray that primarily shows bones, a CT angiogram of arm arteries creates detailed, three-dimensional reconstructions of your vascular system. This allows your radiologist and doctor to see the exact structure and path of your arteries and identify any problems such as blockages (stenosis), complete obstructions (occlusions), bulges (aneurysms), or other abnormalities in the blood supply to your arm. This level of detail is essential for a conclusive diagnosis.

Types of CT Upper Limb Angiography

The CT Upper Limb Angiography procedure is almost always performed with intravenous (IV) contrast. The contrast dye is essential to make the arteries brightly visible and allow the radiologist to assess blood flow accurately. Without it, the arteries would not be distinguishable from other soft tissues.

In some specific clinical situations, a non-contrast CT scan might be performed first. This initial scan can help detect calcium buildup (calcification) in the artery walls or provide a baseline image for comparison. The decision to perform a non-contrast scan first is made by the radiologist based on your unique medical needs.

The scan can also be tailored to the specific area of concern:

• Unilateral: Focuses on imaging the arteries in just one arm.
• Bilateral: Images the arteries in both arms, often done for comparison or if symptoms are present on both sides.

During the analysis of your scan, our expert radiologists meticulously examine the arteries of the upper limb—including the subclavian, axillary, brachial, radial, and ulnar arteries—for any signs of disease or abnormality. Key parameters include:

• Stenosis: The narrowing of a blood vessel, which can restrict blood flow. The report will often quantify this as a percentage (e.g., "70% stenosis").
• Occlusion: The complete blockage of a blood vessel, where no blood can pass through.
• Aneurysm: A weak, bulging, or ballooning spot in the wall of an artery. These can pose a risk of rupture or forming blood clots.
• Dissection: A tear in the inner layer of an artery's wall, which can allow blood to flow between the layers and block normal circulation.
• Arteriovenous Malformation (AVM): An abnormal, tangled connection between arteries and veins that disrupts normal blood flow.
• Extrinsic Compression: When an artery is being squeezed or compressed from the outside by another structure, such as a rib, muscle, or tumor. This is a key finding in conditions like Thoracic Outlet Syndrome.

The detailed images provided by this scan are invaluable for diagnosing a wide array of conditions. Your doctor may order the test for one of the following reasons:

• To Diagnose Thoracic Outlet Syndrome: This condition occurs when blood vessels or nerves in the space between your collarbone and first rib are compressed. A CT Scan for Thoracic Outlet Syndrome can clearly show this compression.
• To Evaluate Trauma: In cases of shoulder dislocation, fracture, or deep injury, this scan can quickly assess for suspected damage to the major arteries.
• To Assess Vascular Insufficiency: To find the cause of poor circulation, which leads to symptoms like pain, coldness, and numbness in the arm.
• To Detect Blood Clots (Thrombosis) or Embolisms: To identify the location and extent of a clot that is blocking blood flow.
• To Plan for Surgery: To create a detailed "road map" of the arteries before procedures like creating an arteriovenous (AV) fistula for dialysis access, performing a bypass graft, or placing a stent.

When and Who Needs to Take a CT Upper Limb Angiography?

Your doctor may recommend a CT Upper Limb Angiography if you are experiencing symptoms that suggest a problem with the blood flow in your arms. Common indications include:

• Persistent arm, forearm, or hand pain, especially with activity
• Numbness, tingling, or weakness in the arm or hand
• A noticeable difference in temperature, with one arm feeling much colder than the other
• A weak or absent pulse in your wrist
• Sores on your fingers that are slow to heal

This test is often ordered for individuals with suspected vascular trauma after an accident, patients with known chronic conditions like Peripheral Artery Disease (PAD), or those being evaluated for anatomical issues like Thoracic Outlet Syndrome. Furthermore, a CT Upper Limb Angiography is a critical tool for pre-operative planning, allowing surgeons to map the arteries in detail before performing a bypass, creating a dialysis fistula, or other vascular procedures.

Benefits of Taking the Test

Choosing to have a CT Upper Limb Angiography offers several significant benefits:

• High Diagnostic Accuracy: It provides clear, unambiguous images that lead to a confident and precise diagnosis of vascular problems.
• Guides Treatment Decisions: The detailed findings help your doctor determine the most appropriate treatment, whether it's medication, a minimally invasive endovascular procedure, or open surgery. [Link to: Peripheral Artery Disease Info Page]
• Fast and Non-Invasive: The scan itself takes only a few minutes to complete and is minimally invasive, requiring only a simple IV injection.
• Comprehensive Evaluation: It allows for the visualization of the arteries from the base of the neck down to the hand in a single examination.

Illnesses Diagnosed with CT Upper Limb Angiography

This powerful diagnostic tool is key to identifying and characterizing several important conditions, including:

• Thoracic Outlet Syndrome
• Peripheral Artery Disease (PAD) of the upper extremities
• Subclavian Steal Syndrome
• Aneurysms and Dissections
• Vasculitis (inflammation of blood vessels)
• Vascular trauma, including pseudoaneurysms and fistulas after an injury

Proper preparation is simple and helps ensure the best possible results from your scan.

• Food and Drink: You will likely be asked not to eat or drink anything for about 4 hours before your CTA arm procedure with contrast. This reduces the small risk of nausea from the contrast dye.
• Clothing: Wear comfortable, loose-fitting clothes. Avoid clothing with metal zippers, snaps, or buttons in the chest and shoulder area. You may be asked to change into a hospital gown for the procedure.
• Inform Our Staff: Be ready to discuss your complete medical history with our technologist. This includes any allergies (especially to iodine), current medications, and past surgeries.

Pre-requisites

Before your appointment at Cadabam's diagnostics, please ensure you have the following:

• Doctor's Referral: A CT Upper Limb Angiography must be ordered by your physician. Please bring your referral form with you.
• Kidney Function Test: If you are over 60, have a history of kidney disease, high blood pressure, or diabetes, you will need a recent blood test (within 30 days) to check your creatinine levels. This ensures your kidneys can safely process the contrast dye.

Best Time to Take the CT Upper Limb Angiography

For most patients, the scan is a scheduled outpatient procedure that can be booked at your convenience. However, in cases of acute trauma, sudden severe arm pain, or suspected acute blockage, the test is performed on an emergency basis at any time, day or night.

Eligibility

Most adult patients are eligible for this scan. However, there are some contraindications:

• Severe Iodine Allergy: Patients with a known severe, anaphylactic reaction to iodine contrast material may not be eligible.
• Severe Kidney Failure: Patients with end-stage renal disease may not be able to receive the contrast dye.
• Pregnancy: This test is generally avoided during pregnancy.

Please let our team know if you are breastfeeding, as we will provide special instructions for after the procedure.

Procedure for Taking a CT Upper Limb Angiography

Our team at Cadabam's diagnostics is dedicated to making your experience as comfortable as possible. Here is what you can expect during your appointment:

1. Preparation: A friendly technologist will confirm your medical history and answer any questions. An intravenous (IV) line, which is a small plastic tube, will be placed in a vein in your arm or hand.
2. Positioning: You will be asked to lie down comfortably on the padded CT scanner table. The table will then gently slide into the center of the large, doughnut-shaped CT machine.
3. Contrast Injection: During the scan, the contrast dye will be injected through your IV line. It is very common to feel a warm sensation spreading through your body and a metallic taste in your mouth. This is a normal effect of the dye and will pass within a minute or two.
4. Scanning: The scanner will begin taking images. You will be asked to hold your arm still and may be asked to hold your breath for a few seconds at a time. The technologist will be in an adjacent control room but can see, hear, and speak with you at all times.
5. Completion: The scanning process is very quick and typically takes less than a minute. The entire appointment, including preparation, usually lasts between 30 and 60 minutes.

Caution Before Taking the Test

For your safety, it is absolutely crucial that you inform the technologist before your scan if any of the following apply to you:

• Pregnancy: If there is any possibility you could be pregnant.
• Allergies: If you have any allergies, especially to medications, iodine, shellfish, or if you have ever had a reaction to a CT contrast dye in the past.
• Kidney Problems: If you have a history of kidney disease, kidney failure, or have had a kidney transplant.
• Diabetes: Specifically, if you are taking the medication Metformin (also known as Glucophage), as you may need to temporarily stop taking it after the scan.