An angiogram is procedure using X-rays and a special dye (contrast), to image blood vessels both arteries and veins. The contrast (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 our “Cath Lab” , which is a theatre with a specialised x-ray machine.
- You will be awake during the procedure but may be lightly sedated.
- The procedure will be done through a vessel in 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 media (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.
- Blood Thinners: 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. These include
- Warfarin, also called Coumadin or Marevan
- Apixaban, also called Eliquis
- Dabigatran, also called Pradaxa
- Rivaroxaban, also called Xarelto
- 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.
What happens after the procedure?
- When the procedure is finished you will be moved onto your own bed and taken to the Day Stay ward.
- 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?
As with all medical procedures, there are risks and benefits, these will be discussed with you by your Doctor. The majority of patients having this procedure experience no problems or complications.
Minor complication include:
- Bleeding under the skin at the wound site- this should improve over a few days, but contact your GP if you have any concerns.
- Bruising at the wound site – it is common to have a bruise for a few weeks.
- Allergy to the contrast medium / dye used. This causes symptoms such as a rash, you should discuss any allergies that you haee with your cardiologist before the procedure. This reaction can occur up to 10 days later. Please advise MCVS if you experience any type of rash. It is important that you seek medical attention. Your GP may wish to contact us.
More serious complications are rare, but may include:
- Damage to the artery in the arm or the leg from the catheter. This could affect the blood supply to that limb.
- Heart Attack
- Kidney damage caused by the contrast media / dye
- Skin / tissue damage caused by radiation, if the procedure is a very long one.
- Serious bleeding
It is important that you discuss any concerns you have with your Doctor and with the nurse during your admission. Your team can give you more information about your level of risk and information about your individual circumstances.