Appointments – Freeman Hospital: (0191) 223 1012 RVI: (0191) 282 5627
What is an Angiogram?
An Angiogram is a way of showing up blood vessels on a special X-ray machine. Using a fluid called ‘contrast medium’ to outline the insides of the vessels, a picture is produced, which is rather like a road map of the arteries or veins.
Why do I need an Angiogram?
Your doctors have detected a problem in part of your circulation. You may already have had a Doppler Ultrasound test to show the site and severity of the problem. An angiogram will show the problem area in more detail.
Who has made this decision?
Your doctors will have discussed your situation with the doctor responsible for performing your angiogram, the “interventional radiologist” (or x-ray doctor). You will have been asked to sign a consent form. You will also be given the opportunity to discuss the various types of treatment because your full and informed consent has to be given prior to treatment. If you do not want this test, the procedure will be taken no further.
What preparation will I need?
Printed instructions will be given to you with your appointment details. You may eat a light meal up to 2 hours prior to the procedure and drink normally. On admission to the Ward you will be asked to put on a hospital gown and your blood pressure and pulses will be checked. As the Angiogram is usually done through the artery in the groin (the femoral artery) you may be asked to shave the skin in this area.
It is very important that you inform the nursing and medical staff about all allergies and medications. If you have had reactions to contrast medium, the dye used for kidney X-Rays (IVPs) and for CT scanning, then you must also tell your doctor about this.
I am a Diabetic. Does this change anything?
Yes. If you are diabetic and take insulin, you may need a drip to keep your blood sugars controlled. This will be discussed with you on the ward prior to the procedure. (see next question also).
I take Metformin Tablets (Glucophage). Does this change anything?
Yes. Metformin (Glucophage) is most commonly taken by diabetic patients to control blood sugar, but occasionally is taken for other conditions. If you are taking Metformin (Glucophage), your preparation for the procedure may change. Please ring the helpline telephone number, as below, at the hospital you are attending and speak to a member of staff, who will be able to advise you.
| Freeman Hospital | 0191 2231012 |
| RVI | 0191 2825627 |
What happens during Angiography and how is it performed?
After the admission procedures on the ward, a nurse will accompany you to the x-ray Department. Here, the radiology nurse will discuss basic details of the procedure with you and the interventional radiologist will answer any further questions you may have. You will be transferred onto the x-ray table, generally flat on your back. The radiologist may place a small plastic tube into a vein in your arm, if sedation is required.
Monitoring devices will be attached to your chest and one finger. A blood pressure cuff will be put on your arm. After the radiologist has checked the pulses in your groins, the nurse will clean the skin in this area with antiseptic fluid and cover the rest of your body with a drape. Local anaesthetic (see below) will be injected into the tissues around the artery and when the skin in this area is completely ‘numb’, a needle will be inserted into the artery through a tiny nick in the skin.
A guide wire is passed through this needle and the needle is then removed. The catheter (a thin tube) can then be threaded over the wire into the artery. The catheter is then placed in the aorta (the large artery supplying the internal organs and the arms and legs). An injection of contrast medium is given through the catheter and will travel through the circulation in your abdomen and legs while the X-Ray machine records the angiogram pictures.
Local Anaesthetic
Your radiologist will ask you to keep quite still while the injections are given.
You may notice a warm tingling feeling as the anaesthetic begins to take effect. Your procedure will only go ahead when you and your radiologist are sure that the area is numb.
If you are not having sedation, you will remain alert and aware of your surroundings.
Your radiologist is always near to you and you can speak to him/her whenever you want to.
Will I feel anything during the Angiogram?
The initial injection of local anaesthetic may cause slight discomfort. During the angiogram pictures the contrast medium is usually injected through a special syringe pump and this may cause a warm sensation all over along with a feeling of ‘passing water’. This is due to the circulation of the contrast medium around your body and is nothing to worry about.
How long will it take?
This varies according to the complexity of the test but expect to spend anything from 30 minutes to 1 hour in the x-ray department.
What happens afterwards?
The radiologist will remove the catheter and press on the puncture site in your groin. You will be taken back to the ward on a trolley. Nurses on the ward will carry out routine observations, such as taking your pulse and blood pressure. They will also check for bleeding or swelling in the groin.
You will generally stay in bed for four hours. If the puncture site is satisfactory when you get up you may go home. You will be unable to drive yourself and a lift must be arranged. At home it is necessary for you to have someone to look after you overnight. You should rest as much as possible for the rest of the day and do not take any strenuous exercise for two days. You should however be encouraged to walk the following day.
What are the risks or complications?
The most common complication is the development of a deep bruise called a haematoma, at the puncture site. In less than 3% of cases a blood transfusion is needed. Very rarely a small operation is required to seal the hole in the artery with a stitch. There is also a small risk of damaging the blood vessels, so that further treatment (usually the X-ray Department) but rarely surgery, is needed.
What happens if the groin starts to swell and bleed when I get home
You should apply firm pressure just above the puncture site in your groin for 10-15 minutes. Telephone the hospital switchboard, (0191) 233 6161, and ask them to contact the on call surgeon who will then advise you.
What are the benefits of having an angiogram?
An angiogram is helpful in confirming the position and extent of arterial disease. This information is vital for planning the most appropriate treatment.
What happens about the results?
Following your examination a report will be sent to the consultant who asked for the test to be done. He will arrange to see you in the clinic.
I need an ambulance. Do you arrange this?
If you need an ambulance, you must ask your GP’s surgery to arrange one. You will need to give them three working days notice. Please inform the department if you are arriving by ambulance as we will arrange your appointment time to fit with ambulance arrivals.
What if I have any comments or suggestions?
Should you have any suggestions or concerns, please make these known to the person conducting your examination or by letter addressed to the hospital that you are attending your examination:
The Departmental Manager
X-ray Department Level 3, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, NE1 4LP
Telephone: (0191) 282 1099
Or:
The Departmental Manager
Main X-ray Department, Freeman Hospital, High Heaton, Newcastle upon Tyne, NE7 7DN
Telephone: (0191) 282 1099
Monday to Friday 8.30am to 5.00pm
Switchboard: (0191) 233 6161 (24 hours)
The Patient Advice and Liaison Service (PALS) can offer on-the-spot advice and information about the NHS. You can contact them on freephone 0800 032 02 02 or email northoftynepals@nhct.nhs.uk
Information produced by: Dr C Nice, Consultant Radiologist
