An angiogram, or angiography, is an x-ray imaging test for arteries, a type of blood vessel, performed by an interventional radiologist. During the test, the radiologist places a catheter (a small tube) into an artery (either through an artery in the groin or wrist) and injects contrast (x-ray dye) into the vessel and takes x-rays of that area.
One of the most common reasons for needing an angiogram is having symptoms that suggest blockage of an artery. This test can identify the exact location where the artery is blocked, if it is severe, and what is causing the blockage.
Another common reason is the presence of an aneurysm in the body. An aneurysm is an area of the vessel (artery) that has ballooned out. Even if this has been detected by other studies such as ultrasound, CAT scan, or MRI (magnetic resonance imaging), an angiogram may be necessary to see more in detail and to plan the method of treatment.
This test has three major steps:
- Insertion of a small catheter (plastic tube) into the body
- Injection of contrast into an artery while x-ray images are being taken
- Removal of the catheter.
1. Catheter insertion:
The interventional staff will wash the skin where the catheter will be inserted and at times this may involve shaving off the hair of that small specific area. The area is usually at the top of the leg around the groin area or on the upper arm. The radiologist will use a local anesthetic (similar to what your dentist uses to numb your mouth) in the skin and deeper tissues. After that, you should only feel pressure when the catheter is inserted into the artery in the numbed area. Using an x-ray screen - like a TV, the radiologist will guide the catheter through your body to the artery that is being studied. You will not feel the catheter moving through your arteries.
2. Contrast injection:
After the catheter is placed into the artery to be studied, contrast will be injected through that catheter while x-ray pictures are being taken. You may feel warm inside while the contrast is being injected, but it lasts only a few seconds. Usually, several contrast injections and x-rays are needed to complete the exam.
3. Catheter removal:
After all the x-rays are taken, a member of the radiology interventional team (radiologist, nurse, or technologist) will remove the catheter from your artery. Removing the catheter should not hurt. Firm pressure will be put on the place the catheter was for 10-20 minutes. This will stop the artery from bleeding.
The angiogram usually takes 1-2 hours to complete. In some cases the test may take longer. If a second procedure is performed at the same time, such as an angioplasty, this will make the procedure longer.
What do I do to prepare for the angiogram?
If you are an Inpatient: Your nurses and doctors will give you instructions.
If you are an Outpatient or admitted the day of your angiogram: These are the instructions to be followed unless other specific instructions have been given to you by your doctor.
1. Do not eat solid foods after midnight on the night before your procedure. You may drink clear fluids and take your medications.
2. If you take the blood thinner Coumadin, you must tell your doctor so that it can be stopped for the appropriate number of days prior to your angiogram.
If you are diabetic and take insulin, ask your doctor about modifying your insulin dose for the day of your procedure.
If you are allergic to contrast (x-ray dye) or iodine, let your doctor know as soon as possible. There are special precautions your doctor and the interventional radiologist can take to prepare you for the angiogram.
Everyone having an angiogram will have blood tests. Usually the blood tests are done two hours before the angiogram. Whether you are an outpatient or inpatient, you will be dressed in a hospital gown and an intravenous (IV) line will be placed in one of your veins. This IV will be used to give you fluids and medicines during the procedure. The IV will stay in place until after the procedure is complete and when the radiologist and/or your doctor says to discontinue it. The radiologist will study your x-rays an discuss the results with your doctor. Your doctor will then decide how to best treat you.
What do I do after the angiogram? Can I go home?
Inpatients: You will return to your room and be observed by your nurse to make sure you are all right and that you do not bleed where the catheter was inserted into your artery. They will let you know when you can eat and drink and get out of bed.
Outpatients: You will be observed in an outpatient area or specified hospital room for 4-6 hours after your angiogram is completed. Hospital staff will observe you to make sure you are all right and that you do not bleed where the catheter was inserted into your artery. After this observation time, if there have been no complications, you can go home. You may not drive yourself home. Have someone else come with you to drive you home.
After you go home there are some things you should/should not do:
1. Relax and take it easy for 24 hours.
2. Drink plenty of fluids.
3. Keep the bandages on the catheter site for a day.
1. Drive or run machinery for at least 24 hours.
2. Do any strenuous exercise or lifting for at least two days.
3. Take a hot bath or shower for at least 12 hours.
4. Smoke for a least 24 hours.
A list of specific instructions will be given to you after the angiogram is completed and these will be explained to you.
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