What is an angiogram?
An angiogram (also known as an arteriogram) is an x-ray examination of your arteries (blood vessels). A specially trained doctor, known as an Interventional Radiologist, performs this x-ray procedure. During the angiogram, a catheter (a small tube) is placed into an artery in your groin or arm. Contrast (x-ray dye) is injected and pictures of the blood vessel of interest are taken.
Why do I need an angiogram?
You may be having symptoms that suggest a blockage of an artery.
- A blocked artery in your leg may cause pain in your leg when you walk.
- Blocked kidney arteries may cause high blood pressure or poor kidney function.
- Blocked arteries to the brain may cause vision problems and weakness.
- An angiogram can identify exactly where the artery is blocked, how severe the blockage is, and what is causing the blockage. The two most common causes of blocked arteries are blood clot or hardening of the arteries.
- You may have an area of an artery that has ballooned out. This area is called an aneurysm. An angiogram may be necessary to see the aneurysm in detail and to plan treatment.
- An angiogram may be used to diagnose problems not able to be figured out by other tests.
- An angiogram is sometimes used to help plan an operation or to help choose the best type of surgery for you. An angiogram helps to provide a roadmap of your blood vessels.
How do I prepare for the procedure?
If you are already a patient in the hospital, your doctors and nurses will provide you with instructions. You will be admitted to the hospital after this procedure, so please follow these listed instructions:
Do not eat any solid food within 6 hours of your scheduled appointment.You may drink clear liquids up to 2 hours before your scheduled procedure.
Notify our department as soon as possible:
- If you take glucophage, insulin, or a blood thinner. You may take your other medications as usual). If you are unable to lie flat on your back for 2-6 hours without difficulty.
- If you have an allergy to x-ray or contrast dye so that we can take the necessary precautions.
- Bring all your medications with you on the day of the procedure.
A nurse will attempt to call you 1-2 days before your scheduled appointment to review these instructions, obtain important medical information, and answer questions and concerns that you may have.
What happens before the procedure?
1. A nurse and an interventional radiologist will talk to you about the procedure in detail. They will answer your questions and ask you to sign a consent form.
2. You will be asked to put on a hospital gown and remove anything metal (such as jewelry) or false teeth/dentures. If possible, you should leave your valuables and jewelry at home.
3. Your family or significant other(s) will be asked to go to our waiting area.
4. An IV will be started to allow us to give you fluids and medications.
5. You may also need lab or blood tests done before the procedure.
What happens during the procedure?
You will be taken into our procedure room where you will be placed on the x-ray table.
An area of your groin or upper arm where the catheter will be inserted will be shaved to reduce the chance of infection. Betadine (a brown-colored iodine soap) will be used to wash this area.
Lidocaine or Xylocaine (a medication similar to what a dentist uses to numb your mouth) will then be injected to numb the skin and deeper tissues. It will sting and burn for a few seconds before the area becomes numb and you may feel some pressure. A nurse will also be present to give you medications to help you relax and to reduce your pain. Because you need to hold your breath while we take some x-ray pictures, you will need to be awake during the angiogram.
The interventional radiologist will guide the catheter through your body to the artery that is being studied. You will not feel the catheter moving. When the catheter is in the correct position, contrast (x-ray) dye will be injected through the catheter while pictures are taken. You will feel warm inside, get a funny metallic taste in your mouth, or feel like you just urinated (passed your water).These sensations only last 10-15 seconds. The angiogram usually takes 2-3 hours to complete.
What happens after the procedure?
After the exam is complete, you will be taken to the recovery room where the Interventional Radiologist will remove the catheter from your artery. This does not hurt. Pressure is held for 10-20 minutes on the insertion site or until the bleeding stops.
If the groin is used, a bulky dressing will be applied. You will need to lay flat for the next 6 hours, keeping your head down, not bending the leg used for the insertion of the catheter.
If the arm is used, your arm will be placed in a sling. This can be removed the following morning.
Next, you will be sent to your hospital room, where the nursing staff will continue to monitor your vital signs, pulses and your puncture site for bleeding. After the six hours of bed rest:
- you may raise the head of your bed 15 to 30 degrees; however, you will need to stay in bed until the next morning.
- you may eat your usual diet, unless you are told otherwise
When can I go home?
When you meet the discharge criteria, you may go home. To be discharged, your vital signs must be stable and your dressing should be clean and dry with no signs of bleeding, drainage, bruising or swelling. Your pulses should also be stable and there should be very little pain at the catheter insertion site.
In addition, you should be able to:
- tell us your name, what the date is, and where you are.
- walk without getting dizzy.
- drink liquids and eat without feeling sick to your stomach.
- go to the bathroom without difficulty.
You will need someone else to drive you home.
What to do after I go home?
1. Relax and take it easy for 24 hours.
2. Drink plenty of fluids.
3. Resume your regular diet.
4. Keep a Band-Aid on the catheter insertion site for the next 24 hours.
5. No shower or hot bath for 24 hours.
6. No driving or operating machinery for at least 48 hours.
7. No strenuous exercising or lifting for at least 2 days..
8. No smoking for at least 24 hours.
Problems you may experience and what to do:
1. In case of bleeding, or the appearance of a large growing lump where the catheter was inserted.
- Apply firm pressure to the site
- Call 911 or local ambulance for transport to the nearest emergency room.
2. If there is a numbness, coolness, or a change in the color of the arm or leg where the catheter was inserted, go to the nearest emergency room.
3. If a urinary catheter was used during your hospital stay, call your doctor if you notice burning upon urination, frequency of urination, pain or fever.
What are the risks of an angiogram?
With modern techniques, angiography is safe. However, because the exam includes the use of catheters in your arteries and the use of contrast injection, there is some risk to you.
Placing a catheter in your artery, can damage it. Even when it has not been damaged, you may have a bruise or small lump where the catheter was inserted. The bruise or lump may be sore, but will go away if a few days to a week.
A few patients get ill from the contrast injection. Patients with diabetes, kidney disease, asthma, or previous allergic reaction to contrast (x-ray dye) tend to get sick more often. If you have one of the above conditions, please let your Interventional Radiologist know before your procedure begins.
Other complications can occur. What they are depends on what artery is being studied. The exact risks of your angiogram will be discussed with you in more detail a member of the interventional radiology team before your procedure begins.
What is the benefit of having an angiogram?
The benefit of angiography is that it can give your doctors exact information about your arteries and help them plan the best treatment for you.
For any questions or concerns
Contact the Radiology and Medical Imaging department at 434-924-9400.