Angiography * What is Angiography? * What happens during an Angiogram? * How do you prepare for an Angiogram? * What will you feel during the Angiogram? * What is angioplasty? * What is a stent? * What are the different kinds of Angiogram? What is Angiography? Angiography is a special X-ray procedure that takes pictures of your blood vessels. Angiography is performed to image and diagnose diseases of the blood vessels in the body. An interventional radiologist places a catheter, which is a small tube, into one of your arteries and injects contrast (dye) into the vessels while taking X-rays of this area. Angiography is now used to guide balloon angioplasty catheters and stents that stretch the walls of a narrowed blood vessel, restoring normal blood flow without surgery. What Happens During an Angiogram? Patients report first to the ambulatory services department. Here you will be prepared for your examination. This will usually include having lab work done, an IV started and your groin area shaved. Your vital signs will be taken and your nurse will take a short history of illnesses and medications you take. This part of the procedure can take up to 2 hours. Next you will be taken to the Angio Suite in the radiology department. You will be positioned on the X-ray table by the technologist so that the area of interest is in the proper field of view. You will have EKG patches placed on you chest, a blood pressure cuff on your arm and oximeter probe on your finger. This allows you to be monitored throughout the procedure. The nurse will ask you if you feel you need medication to help you relax and will give it at this time. Your groin will be prepped for the procedure and you will be completely covered with a sterile drape. You will be asked to keep your arms at your sides during the procedure. If you experience any discomfort from the position, please tell the nurse or technologist and they will try to make you as comfortable as possible. The radiologist and technologist will remain at your side throughout the procedure. The doctor will inject a local anesthetic in the groin area. A small incision is made and a puncture of the femoral artery or vein will be done. A catheter is inserted into the vessel over a guide wire. Once in place, the guide wire is removed and contrast material is injected so that X-ray pictures can be taken of the vessels. Several projections will be taken with a special machine called a C-arm, which moves around you at different angles. Once the radiologist has all the pictures he needs, the pressure over the artery for 15 to 20 minutes until soft clot forms. If we are imaging a vein, pressure will be held for a shorter period of time. When a clot has formed and we are able to move you, we will slide you over to a softer cart for your recovery period. You will be taken back to ambulatory services or to a hospital room for this recovery time. Depending upon the procedure, you may be there anytime from four hours to an overnight stay. You may resume normal activities the day following your angiogram. You should not do any heavy lifting or excessive stair climbing for a day or two. How Do You Prepare for an Angiogram? You will be asked to stop any blood thinning medication you are taking for several days before the procedure. You will be asked not to eat or drink after midnight the day before your exam. If you have allergies to contrast media, iodine or shellfish you will be asked to take medication the night before your procedure. It is recommended that someone bring you to the hospital and take you home, as you should not drive following this test. Arrangements should be made to have someone sty with you if you return home the same day as your test. What Will You Feel During the Angiogram? The local anesthetic will feel like a sting, lasting only a few seconds. You will feel pressure from the doctor's or technologist's hands when they press on your groin. Should you receive sedation to make you more comfortable, you will still be awake and aware of what is happening during the procedure. We need you to be able to hold your breath and answer question during the exam. You will not feel the catheter in your body. You may feel a slight warm sensation when the X-ray dye (contrast) is injected. If we are taking pictures of the arteries in your head, you may feel a warm flush on the sides of your face when we inject contrast. This passes quickly. You may experience some minor discomfort immediately after the procedure when the technologist or nurse is holding pressure on your groin. What is Angioplasty? Angioplasty is a procedure introducing a balloon, mounted on a catheter, into a narrowed blood vessel, stretching the walls of the vessel to restore normal blood flow. Angioplasty is performed on short areas of the narrowing in a blood vessel. If a long segment of a vessel is narrowed, surgical intervention is necessary. Stents are small, flexible tubes that look like wire mesh. They are implanted in the vessel to hold the walls of the vessel open. Stents can be placed during the angioplasty procedure. These are permanent implants. Many new stents are made of materials that are safe for having MRI examinations. What is a Stent? A stent is a small flexible tube made of medical grade metals or plastics. It expands within the vessel to hold the vessel open so that normal blood flow can occur. What Are the Different Kinds of Angiogram? 1. Carotid DSA 2. Abdominal Aortogram with Runoff (Lower Extremity Arteriogram) 3. Angioplasty / Stent Placement 4. Biliary Tube Placement 5. Inferior Vena Cava Filter Placement 6. Nephrostomy 7. Renal Arteriogram 8. Shuntogram 9. Thrombolytic Therapy