An angiogram is an X-ray imaging test used to diagnose a variety of vascular conditions, including aneurysms.
Sometimes physicians use angiography to treat aortic problems such as dissolving a clot, performing angioplasty and performing a stenting procedure to clear a blockage. An angiogram can also help your physician plan operations to repair the arteries for more extensive problems.
Preparing for An Angiogram
Prior to the procedure, your physician will perform blood tests to determine your blood’s ability to clot and assess your kidney function. Your surgeon will also instruct you on what medications you may take prior to and after the angiogram; for example, if you have allergies to the contrast material or to iodine or shellfish, you may require medication before the test to lessen your risk for an allergic reaction.
There will be a specialized X-ray machine in the procedure room. An angiogram usually takes about an hour though it may be longer if stenting or angioplasty is performed as well. Typically, your procedure will follow these steps:
- An IV will be inserted to deliver fluids and medications.
- An angiographic catheter will be inserted into an artery in your groin.
- Your physician will numb your skin with a local anesthetic and make a tiny puncture to reach the artery.
- Your artery will be punctured with a hollow needle and a thin wire is advanced through the needle.
- The needle threads a catheter over the wire which is guided to the desired location.
- X-rays are projected on a video screen, a process called fluoroscopy, to follow the catheter as it moves through your arteries. The X-ray table is generally moved to follow the catheter as it navigates through your blood vessels to the proper place.
- Contrast dye is injected. The contrast causes a brief, mild warm feeling as it enters your bloodstream. Your physician takes more X-ray images to see how the contrast is flowing through your arteries.
- You may be asked to hold your breath for a few seconds and to lie perfectly still to avoid blurred pictures.
When the test is over:
- Your physician will remove the catheter and pressure will be placed on the insertion site for 10 to 20 minutes to help stop bleeding. You’ll be instructed on how to position your body for minimal bleeding.
- You will also be monitored for about 6 hours after the procedure and provided with fluids to prevent dehydration and to flush the contrast dye from your kidneys.
- Once any bleeding from the insertion site has stopped and your vital signs are normal, your physician will tell you that you can leave. Since you cannot drive immediately after an angiogram, arrange for a ride home.
Your physician will provide you with at home instructions which you should follow. Typical instructions include:
- Eat normally
- Continue drinking extra fluids for one to two days
- For at least 12 hours after the angiogram, avoid strenuous physical activities such as climbing stairs, driving, and walking
- You should be able to resume normal activities within a day or two of the procedure
Complications from angiography may include:
- Bleeding, pain or swelling where the catheter was inserted, or pain, numbness or coolness in your arm or leg. These symptoms may signify either bleeding from the puncture site or blockage of your artery.
- Bruising at the puncture site is common and usually resolves on its own.
- Rarely, impaired kidney function, or kidney failure, can occur following an angiogram, especially if you already have kidney disease.
- Also rarely, severe allergic reactions can occur, especially among people who have had previous allergic reactions to the contrast dye.
- Infrequently, a patient may experience shortness of breath or fluid overload if they have a heart condition associated with poor pumping action, such as congestive heart failure.