An angiogram is a procedure that uses an X-ray image to show us what the inside of an artery or vein looks like. Contrast material (dye) is injected into the artery or vein through a catheter to outline the inside of the vessel. An x-ray is taken at the time of injection showing the picture on a screen.
It is a gold standard method of determining if a vessel has any narrowing/ blockage or ballooning in the walls of the artery or vein.
How is an angiogram performed?
- The procedure is conducted in a “Cath Lab” ( a specialised theatre where procedures are carried out)
- You will be awake during the procedure but may be lightly sedated.
- The procedure will be done through either your wrist or groin depending on where the specialist chooses.
- You will receive local anaesthetic before the artery or vein in your wrist or groin is accessed .
- A needle is put into your vein or artery and a wire, then a sheath is placed and a catheter is passed into and up the artery or vein that is needed to be x-rayed.
- As the contrast material flows through the veins being examined, several x-rays are taken. These are shown on a ‘live’ screen that the specialist reviews at once.
Why do I need an Angiogram?
An angiogram provides your specialist with very precise information about the function of your heart and the extent of any narrowings in the coronary arteries (if you are having a cardiac angiogram) and any narrowings or aneurysms (ballooning) of your peripheral arteries (any vessel other than those in the heart.)
The procedure allows your Specialist to make the best decision about which form of treatment is the most appropriate for you.
Your Specialist will discuss the findings of the test with you and your family (if present) shortly after the completion of your procedure.
How should I prepare for the procedure?
- Please have your blood tests done at least a day prior to the procedure.
- Eating and drinking: You will be advised on your information sheet when to stop eating and drinking.
- Allergies or previous reactions to contrast (x-ray dye): Please inform the booking clerk if you have any allergies and especially if you have an allergy to contrast. If necessary you will be sent a prescription for drugs to suppress the reaction.
- Diabetes: Please tell the booking clerk when you are contacted that you are a diabetic. Your blood sugar levels will be monitored while you are with us. If necessary a nurse will discuss a plan for your diabetic management.
- Warfarin or Pradaxa (dabigatran): If you are taking a “blood thinner” other than asprin (please do not stop your asprin) please tell the booking clerk. It is likely that you will need to stop this medication temporarily for a few days before angiography.
- Other usual medications: Continue these unless advised otherwise by your cardiologist. In particular, please continue taking your aspirin. Please bring with you any medication that you are taking. This is important.
- It is important to tell us if you have Obstructive Sleep Apnoea.
- If you use a C-Pap machine: please bring it with you. We will use it if giving you sedation and if staying over night you will need to have it with you.
- Skin preparation: You do not need to do any skin preparation yourself other than normal hygiene. We will shave your groin and wrist if necessary.
- Safety: You need to either stay in our facility overnight or to have a responsible adult stay with you overnight in other accommodation. We advise that you do not drive for 24 hours. If your angiogram proceeds to angioplasty you May not drive for 48 hours. This is an LTSA legal requirement
What happens after the procedure?
- When the procedure is finished you will be moved onto your own bed and taken to Day Stay
- The catheter or sheath is removed from the artery and pressure applied.
- If the procedure is done through your wrist, a small pad will be placed over the needle site and inflated to prevent bleeding.
- Your cardiologist will discuss their findings with you while you are in hospital
- After the procedures, patients are usually discharged on the same day but under some circumstances, a patient may need to stay overnight.
- If you have treatment of a narrowing with percutaneous coronary intervention (PCI or stenting) you will be required to stay overnight.
- You need to either stay in our facility overnight or to have a responsible adult stay with you overnight in other accommodation. We advise that you do not drive for 24 hours. If your angiogram proceeds to angioplasty you May not drive for 48 hours. This is an LTSA legal requirement. You cannot go home alone in a taxi.
- Your specialist will advise you when you can return to work.
What are the risks?
- These will be discussed with you prior to your procedure by either your own specialist or the person who is doing the procedure.
- There are risks associated with any medical procedure. Angiography is no exception. In the vast majority of patients the procedure causes no problems or complications.
- Technical problems with the needles, catheters, guides and other pieces of equipment are rare but do occur. Most of these problems can easily be dealt with during the procedure.
- Damage to the arteries is rare but can occur, causing bleeding or subsequent damage to other parts of the body.
Blockages of arteries causing pain or numbness in the arms or legs can also occur if the groin is used for the procedure. Blocked access artery less than 0.3% (3 in a thousand)
- For those having cardiac angiography: A heart attack or a stroke is a very rare complication. Heart attack less than 0.2% (2 in a thousand,) stroke less than 0.3% (3 in a thousand.)
- People having angiograms of the neck or brain should be aware that some patients have developed partial strokes (causing weakness of the arms or legs, or problems with speech or vision,) either during or immediately after the angiogram. In very few cases these strokes have been permanent.
- As part of this examination you will need to have injections of CONTRAST AGENT. In the vast majority of people this injection causes NO complications or problems. An allergic reaction to the x-ray contrast (dye) with rash or itching, sometimes occurs. Exceptionally rarely, a very severe life-threatening allergic reaction can occur. Please note: This reaction can occur up to 7 days later. Please advise MCVS if this occurs. It is important that you seek medical attention. Your GP may wish to contact us or read our advice on this website.
- Sometimes a “false aneurysm” or out-pouching of the artery deep under the skin occurs at the puncture site. This shows up as increasing pain at the puncture site. The diagnosis is made by an ultrasound scan and treatment is usually by an injection.
- The x-ray contrast may cause some damage to kidneys that is usually temporary. It is more common in those patients who already have damaged kidneys or who suffer from diabetes.
- Infection is rare.