Angiogram

An angiogram is done to:

• Detect problems with blood vessels that affect blood flow. Examples of such problems include a tear in a blood vessel (which can cause blockage or internal bleeding), aneurysms (which are weaknesses in the blood vessel wall), and narrowed areas.
• Look for changes in the blood vessels of injured or damaged organs.
• Show the pattern of blood flow to a tumor. This can not only help show how much the tumor has spread but also guide treatment.
• Show the condition, number, and location of renal arteries before a kidney transplant.
• Look for a source of bleeding, such as an ulcer.
• Prepare for surgery on diseased blood vessels of the legs (peripheral arterial disease) in people who have severe leg pain when walking.
• Check how bad atherosclerosis is in the coronary arteries.

In some cases, a method called interventional radiology may be used during an angiogram to treat diseases. For example, a catheter can be used to open a blocked blood vessel, deliver medicine to a tumor, or stop intestinal bleeding caused by diverticular hemorrhage. To stop intestinal bleeding, the catheter is moved into the small artery where the bleeding is occurring, and medicine that narrows the artery or causes the blood to clot is injected through the catheter.

An angiogram can be done by different types of doctors, including a radiologist, a cardiologist, or a surgeon. Your doctor may be helped by a radiology technologist or a nurse.

You will need to take off any jewelry. You may need to take off all or most of your clothes. You will be given a gown to wear during the test.

During the test

You will likely have an intravenous (I.V.) line in a vein in your arm so your doctor can give you medicine or fluids if needed. Small pads or patches (electrodes) are placed on your arms, chest, or legs to record your heart rate and rhythm.

You will lie on your back on an X-ray table. A strap, tape, or sandbags may be used to hold your body still. A lead apron may be placed under your genital and pelvic areas to protect them from X-ray exposure.

A round cylinder or rectangular box that takes the pictures during fluoroscopy will be moved above you. The fluoroscope will move under you during the test.

The place where the catheter will be inserted (in the groin or above the elbow) will be shaved and cleaned. Your doctor will numb the area with a local anesthetic. Then the doctor will put a needle into the blood vessel. A guide wire will be put through the needle into the blood vessel and the needle will be removed. The catheter will be placed over the guide wire and moved into the blood vessel. The catheter then will be guided through the blood vessels until the tip is in the area to be studied. Your doctor will use the fluoroscope to watch the movement of the catheter in the blood vessels.

When the catheter is in place, the dye is injected through it. You may be asked to take a breath and hold it for several seconds. Several X-ray pictures will be taken one after another. These will be available right away for your doctor to look at. You need to lie very still so the pictures are clear. More pictures may be taken.

After the test

The catheter is taken out after the angiogram, and pressure is put on the needle site for 10 to 15 minutes to stop any bleeding. A bandage or compression device is put on the site. This will prevent bleeding. You will be given pain medicine if you need it.

If the catheter was put in your groin, you will need to lie still and keep your leg straight for several hours. The nurse may put a weighted bag on your leg to keep it still. If the catheter was put in your arm, you may be able to sit up and get out of bed right away. But you will need to keep your arm still for at least 1 hour.

Do not eat or drink for 4 to 8 hours before the angiogram. You may be asked to not take aspirin, aspirin products, or blood thinners for several days before the test and for 1 day after the test. If you take these medicines, talk with your doctor.

An angiogram can be done as an inpatient or outpatient. If you are an outpatient, you will stay in a recovery room for several hours before you go home. Arrange to have someone take you home because you may get a sedative before the test. If you stay overnight in the hospital, you will probably go home the next day.

Also before the angiogram you may have other blood tests, such as blood clotting (coagulation) studies and tests for blood urea nitrogen (BUN) and creatinine.

Your doctor may tell you some results right after the test. Full results are usually ready the same day.