Angiography

An angiogram is a specialised x-ray that can demonstrate narrowing or blockage in the arteries. It is usually undertaken before major surgery to give a “roadmap” of the arteries.

Why should I have an Angiogram?

Angiograms provide very accurate and detailed information about blockages or narrowing in arteries.

Angiography is generally advised if treatment of arterial problems is being considered and the ultrasound has demonstrated abnormalities.

The combined information from the ultrasound and the angiogram help in advising you about treatment.

Where is the Angiogram performed?

Angiography and angioplasty are performed at the Sunshine Coast Private Hospital in Buderim.

How long Am I in Hospital?

Most patients are admitted to hospital on the morning of their procedure. Patients with diabetes or kidney impairment are generally admitted the day before for intravenous fluids.

Patients on anticoagulants, such as warfarin, may need admission 2 days before their procedure for Heparin treatment.

Most patients who undergo routine angiography will be able to go home that afternoon provided a responsible adult is at home.

Angioplasty patients will stay in hospital for 1 night after their procedure.

What Does Angiography Involve?

Angiography is performed under local anaesthetic. A small needle is placed within the artery of the groin (femoral) or the arm (brachial). Through this needle a wire is passed into the artery and then a thin tube. An Iodine based die is then injected into the artery and x-rays of the arteries are taken. At the conclusion of the procedure the small tube is removed from the artery and pressure is applied to the region for about 20 minutes to stop any bleeding from the small hole in the artery. Patients should then lie quietly on their backs for a further 6 hours. During this time they can eat and drink with care. The puncture site in the groin or the arm will be regularly checked by the nursing staff. Provided no problems occur with the puncture site then patients with a responsible adult at home can be discharged. Patients who live alone will probably stay overnight. Patients should ensure they have a review appointment following their angiogram.

Risks

The great majority of patients who undergo routine angiography have no major problems. Most patients will get a warm feeling in the pelvis when the dye is injected and some bruising and perhaps a small lump at the puncture site. Other complications can occur but are relatively uncommon. The following complications are well recognised. This list is not exhaustive.

Allergy to contrast (Dye)

Like any medication the dye used could cause an allergic reaction in a small percentage of patients. If you have any history of contrast allergy or allergy to iodine or seafood you should make this known. Patients with possible allergy are usually given medicine to take before their angiogram to reduce the chance or severity of an allergic reaction. Angiograms are performed in hospital with experienced staff and facilities to deal with possible allergic reactions.

Contrast and kidney damage

If your kidneys are not working properly before your angiogram then the contrast could make the kidneys worse. Most patients will have a blood test to check on their kidney function before their angiogram. If the kidneys are working well before the angiogram it is very unlikely that the dye will affect them. Patients with known kidney disease will sometimes be admitted to hospital a little earlier for intravenous fluids to help protect the kidneys.

Vessel damage

Angiography is a test that requires a needle, wire and small tube to be placed inside an artery. In some instances, this can result in damage to an artery and rarely an emergency operation is necessary to repair the artery.

Angioplasty and Stenting

Angioplasty is the technique of widening a narrowed artery with a balloon. The procedure is performed in much the same way as a routine angiogram. Local anaesthetic is used and a small tube is placed in the artery, usually in the groin. A balloon is then advanced into the narrowed section of the artery. As the balloon is inflated the narrowing is dilated or widened. The balloon is then collapsed and removed through the small tube. Sometimes the narrowing will “spring” back or the balloon may cause some damage to the artery. In this situation a stent may be used. Stents are flexible metal tubes that resemble a roll of very fine chicken wire. They are placed in the artery in the same way as the angioplasty balloon but are left inside the artery. Stents help to keep the artery open. Following angioplasty and removal of the tube from the groin, pressure will be applied for about half an hour and you should lie quietly in bed for a further 8 hours. All angioplasty patients should remain in hospital for one night.

Risks of Angioplasty and Stenting are much the same risks as angiography with the additional risks of damaging the artery with the balloon or stent or placing the stent in an incorrect position. In these uncommon situations emergency operations may be required. It is important however to remember that the great majority of patients who undergo angiography or angioplasty and stenting have no serious complications. Bruising and a small lump are common but will usually resolve fairly quickly. Successful angioplasty may mean that a large open operation can be avoided.