Angiography
(Catheter Angiography, Arteriography, Angiogram)

Definition

An x-ray exam of the blood vessels when they are filled with a contrast material (a substance that makes the blood vessels visible on an x-ray).

Angiography

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Parts of the Body Involved

Can be used in blood vessels throughout the body. It is most commonly used in the:

• Heart
• Brain
• Kidneys
• Legs or arms

Reasons for Procedure

This procedure is performed to help doctors identify diseased, narrowed, enlarged, and blocked blood vessels, and to determine where internal bleeding may be occurring. It is specifically used to:

• Detect atherosclerosis (narrowing of the arteries), which could lead to a heart attack or stoke
• Identify an aneurysm (ballooning out of a section of a blood vessel) in the brain
• Evaluate disease in kidney arteries and help prepare for a kidney transplant
• Plan an operation or choose the best procedure for surgery
• In some cases, the doctor can treat a blocked blood vessel when an angiogram is performed. This can prevent the need for another procedure.

• At your appointment before the test, your doctor will likely:
  • Do blood tests
  • Ask about:
    • Your medical history
    • Medications you take
    • Allergies
    • Whether you are pregnant or trying to get pregnant
  • Perform a thorough physical examination
• In the days before your procedure:
  • Arrange for a ride to and from the procedure.
  • Follow your doctor's instructions regarding any changes in how you take your medications and any restrictions on your eating and drinking.
• At the hospital:
  • A healthcare professional explains the procedure and answers any questions you may have.
  • You remove all your clothes and jewelry and put on a hospital gown.

Anesthesia -

Local anesthetic is injected in the area of the groin or arm where the catheter will be inserted. A small dose of sedative may be given by IV.

Description of the Procedure -

The area of the groin or arm where the catheter will be inserted is shaved, cleaned, and numbed with local anesthetic. The radiologist (doctor who specializes in working with medical images like x-rays) makes a small incision in your skin so that a catheter can be placed into an artery. A catheter is a very thin, flexible tube. The doctor guides the catheter through the arteries to the area to be examined and injects the contrast material. The doctor watches the procedure with a fluoroscope, an x-ray unit with a television monitor. Several sets of x-rays are taken. Then the catheter is removed. The incision site is closed by placing pressure on it for about 10 minutes.

After Procedure -

You will need to lie flat for two to six hours depending on your overall health and the reason for the exam. If you notice any swelling, bleeding, black and blue marks, or pain where the catheter was inserted, tell the nurse. You will be encouraged to drink a lot of fluids to flush the contrast material from your system. You may be allowed to leave the hospital after this recovery period, or you may have to stay up to a day for more observation and recovery.

How Long Will It Take -

Less than an hour to several hours

Will It Hurt -

Although the procedure is not painful, you may feel the following discomfort:

• Brief sting when local anesthesia is injected
• Pressure when catheter is inserted
• Hot and flushed when contrast material is injected

Possible Complications -

Complications are rare but may include:

• Allergic reaction to contrast material
• Arrhythmias (abnormal heart beats)
• Bleeding at point of catheter insertion
• Blood clots, possibly resulting in heart attack, stroke, kidney damage, lung injury, or damage to arms or legs
• Catheter damage to blood vessels
• Kidney damage from contrast material
• Infection

Average Hospital Stay -

0-1 day

Postoperative Care -

When you return home after the procedure, do the following to help ensure a smooth recovery:

• Drink extra fluids, as instructed by your doctor, to help flush the contrast material from your system.
• Do not lift heavy objects or do any strenuous exercise or sexual activity for at least 24 hours or longer as directed by your doctor.
• Change the dressing around the incision area as instructed.
• Take medications as instructed.

Outcome

The radiologist will examine the x-rays and report the findings to your personal doctor. Your doctor will discuss the findings with you and any treatment options needed.

Call Your Doctor If Any of the Following Occurs

It is essential for you to monitor your recovery once you leave the hospital. That way, you can alert your doctor to any problems immediately. If any of the following occur, call your doctor:

• Redness, swelling, increasing pain, excessive bleeding, discharge at point of catheter insertion
• Signs of infection, including fever and/or chills
• Extreme sweating, nausea, or vomiting
• Leg or arm feels cold, turns white or blue, or becomes numb or tingly
• Extreme pain, including chest pain
• Difficulty breathing