Q- What is an angiogram?
Ans- An angiogram is procedure where x-rays are used to
examine blood vessels. Normally, blood vessels do not show up on an ordinary
x-rays and a special dye, called contrast medium, is injected into the artery
through a fine plastic tube called a catheter. X-rays are then taken
immediately afterwards, producing detailed images of arteries and veins.
Q- Why do I need an angiogram?
Ans- The reason you may require an angiogram is that there
may be a problem with your circulation. Previous tests that have been carried
out such as a Doppler ultrasound can provide useful information, but it may not
be the best way of obtaining the amount of detail required by an angiogram.
Q- Who has made the decision?
Ans- The consultant in charge of your case and the
radiologist doing the angiogram believe this is the next step. However, you
will also have the opportunity for your opinion to be taken into account, and
if, after discussion with your doctors, you do not want the procedure carried
out, you can decide against it.
Q- Who will be doing the angiogram?
Ans- A specially trained doctor called a radiologist.
Radiologists have special expertise in using x-ray and scanning equipment, and
also in interpreting the images produced. They will look at these images while
carrying out the procedure.
Q- Where will the procedure take place?
Ans- Generally in the x-ray department.
Q- How do I prepare for an angiogram?
Ans- You will be asked to put on a hospital gown. As the
procedure is generally carried out using the big artery in the groin, you may
be asked to shave the skin around this area. You may receive a sedative to
relieve anxiety.
If you have any allergies, you must let your doctor know. If
you have previously reacted to intravenous contrast medium (the dye used for
kidney x-rays and CT scans), you must also tell your doctor about this.
Q- Can I bring a relative/friend?
Ans- Yes, but for reasons of safety they may not be able to
accompany you into the x-ray room, only in very special circumstances.
Q- What happens during an angiogram?
Ans- You will lie on the x-ray table, generally flat on your
back. You may have a needle put into a vein in your arm, so that the
radiologist can give you a sedative or painkillers. You may have a monitoring device
attached to your chest and finger, and may be given oxygen through small tubes
in your nose.
The radiologist will keep everything as sterile as possible,
and may wear a theatre gown and operating gloves. The skin near the point of
insertion, probably the groin, will be cleaned with antiseptic, and then the
rest of your body will be covered with a theatre towel.
The skin and deeper tissues over the artery will be
anaesthetised with local anaesthetic, and then a needle will be inserted into
the artery. Once the radiologist is satisfied that this is correctly
positioned, a guide wire is placed through the needle, and into the artery.
Then the needle is withdrawn allowing a fine plastic tube called a catheter to
be placed over the wire and into the artery.
The radiologist uses the x-ray equipment to make sure that
the catheter and the wire are moved into the right position, and then the wire
is withdrawn. A special dye, contrast medium, is then injected through the
catheter and x-rays are taken. Once the radiologist is satisfied that the
x-rays show all the information required, the catheter will be removed.
Q- Will it hurt?
Ans- Some discomfort may be felt in the skin and deeper
tissues during the injection of the local anaesthetic. After this, the
procedure should not be painful. There will be a nurse, or another member of
clinical staff, standing nearby looking after you. If the procedure does become
uncomfortable they will be able to arrange for you to have a painkiller through
the needle in your arm. As the dye, or contrast medium, passes around your
body, you may get a warm feeling, which some people can find a little
unpleasant.
Q- How long will it take?
Ans- Every patient’s situation is different, and it is not
always easy to predict how complex or how straightforward the procedure will
be. Depending on the location of the procedure, for example, if looking at a
large artery in the leg, this could take half an hour, if looking at smaller
arteries it may be more complex and take longer possibly up to an hour. As a
guide expect to be in the x-ray room for two hours altogether.
Q- What happens afterwards?
Ans- You will be taken back to your ward on a trolley.
Nurses on the ward will carry out routine observations, such as taking your
pulse and blood pressure, to make sure that there are no problems. They will
also look at the skin entry point to make sure there is no bleeding from it.
You will generally stay in bed for a few hours, until you have recovered. You
may be allowed home on the same day, or kept in hospital overnight.
Q- Are there any risks or complications?
Ans- An angiogram is a safe procedure, but there are some
risks and complications that can arise. There may be a small bruise around the
site where the needle has been inserted and this is quite normal. There is a
chance that the bruise may become very large and uncomfortable, but this does
not happen very often.
If a large bruise develops, there may be a risk of it getting
infected, and this would be treated with antibiotics. In some hospitals, a
large bruise is treated by having a small operation to drain it. As with any
mechanical device, there is also the possibility the catheter may fail. Despite
these possible complications, the procedure is normally very safe, and is
carried out with no significant side-effects at all.
Q- When will you get the results?
Ans- The scan will be examined after your visit and a
written report on the findings sent to your referring doctor which is normally
available in 14 days.
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