After appropriate sedation and local anesthetic, a small tube (catheter) is inserted, usually in the artery at the groin (femoral artery). This small tube is guided under the video x-ray to the arteries of interest. A fluid which is dense on x-rays, called contrast, is injected through the tube to fill the vessels and visualize the anatomy. From this information, the diagnosis of the various disorders and injuries to the blood vessels can be made.
Endovascular treatment (embolization and revascularization) of blood vessel disorders such as aneurysms, malformations, fistulae, stenoses, and others is done in the same manner of access, but with the addition of even smaller catheters (microcatheters) or other devices appropriate for the specific problem.