What is an angiogram?
An angiogram is a procedure that uses X-rays to view the blood vessels in your body. This test is often performed to study narrow, blocked, enlarged, or malformed arteries in many parts of your body, including your brain, heart, abdomen, and legs.
- Blockages of the arteries outside of your heart, called peripheral artery disease (PAD)
- Enlargements of the arteries, called aneurysms
- Kidney artery conditions, called reno-vascular conditions
- Problems in the arteries that branch off the aorta, called aortic arch conditions
- Malformed arteries, called vascular malformations
Physicians are able to treat a problem during an angiogram. In some instances, your physician may dissolve a clot that is discovered during the test. An angioplasty and stenting procedure to clear blocked arteries can be done during an angiogram, depending on the location and extent of the blockage. An angiogram can help your physician plan operations to repair the arteries for more extensive problems.
How do I prepare?
Blood tests will be performed to determine your blood’s clotting ability and to assess your kidney function. Based on the test results, your physician may instruct you to stop taking aspirin or other drugs that prevent clotting. Your physician will tell you which medications you should continue to take. Usually your physician will ask you not to eat or drink anything within six hours of your angiogram. Because you shouldn't drive after an angiogram, you should bring someone who will drive you home and stay with you.
What are the risks?
If you have blood clotting problems, kidney problems, or are at an advanced age, your risk for developing complications during and after an angiogram can be increased. Allergies can increase your risk of a reaction to the contrast dye. Some complications that can occur from an angiography include bleeding, pain, or swelling where the catheter was inserted, and pain, numbness, or coolness in your arm or leg. Puncture site bruising is common and usually resolves on its own.
How is it done?
Your test will take place in a room equipped with a specialized X-ray machine. Your physician will insert an IV to provide you with fluids and medications and will choose where to insert the catheter, usually into an artery in your groin or your elbow.
Before the catheter is inserted, your skin will be cleaned and any hair at the site will be shaved to help reduce your risk of infection. Your skin will be numbed with a local anesthetic. The chosen artery is punctured with a hollow needle and a thin wire advances through the needle. A catheter is threaded over the wire, and it is guided to the desired location. X-rays are projected on a video screen to see the catheter as it moves through your arteries.
Once the catheter has been positioned properly, the contrast dye is injected. The contrast causes a brief, mild warm feeling as it enters your bloodstream. More X-ray images are taken to see how the contrast is flowing through your arteries. During the test, you may be asked to hold your breath for about five to 15 seconds. In addition, you may be asked to lie perfectly still to prevent sudden movements from blurring the X-ray pictures.
When the test is over, the catheter will be removed, and the insertion site will need to have pressure applied for 10 to 20 minutes to help stop bleeding.
Angiograms generally take about one hour to complete if only X-rays are required. It may take longer if your physician also performs angioplasty and stenting.
What can I expect after an angiogram?
After the test, you will be monitored in the hospital for about six hours. During this time, you should keep the arm or leg that was punctured straight to minimize bleeding from the puncture site.
You will be asked to drink fluids to prevent dehydration and flush the 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.
At home, you can eat normally, but you should continue drinking extra fluids for one to two days. Avoid physical activities such as climbing stairs, driving, and walking for at least 12 hours after the angiogram. You may be able to resume normal activities within a day or two of the procedure.