Angiography is an invasive test used to evaluate the patency of your arteries. Angiography can be used to investigate several different arteries including but not limited to your heart, neck (carotids), kidneys, or legs. Angiography involves the insertion of a catheter into an artery, usually located in the groin (femoral artery) but sometimes in the arm (brachial artery), or wrist (radial artery. Your physician may order this test for you if you have experienced pain, numbness or tingling, had an abnormal non-invasive test, have poorly controlled blood pressure (hypertension), and /or many other reasons.
What to Expect: Angiography is performed in the hospital. You will be required to disrobe. You will be administered medication for relaxation; however, you will be able to respond and will NOT be under general anesthesia. Small electrode pads will be placed onto your chest to monitor your heart rate and rhythm (similar to an EKG) throughout the procedure. A blood pressure cuff will be placed on your arm to monitor your blood pressure throughout the procedure. An IV (intravenous) catheter will be inserted, most likely into your arm. Your groin area will be cleansed with a sterilized wash and some may require the area be shaved. You will also receive local anesthesia to the groin area, so the insertion site will be numb. Your physician will then make a small puncture site into your skin with a needle. The needle goes into the artery in your groin area. If a wrist approach (radial artery) is chosen, the wrist will be cleansed and placed in proper position for the study. A small plastic tube called an introducer sheath, and a special guide wire will be thread into the artery. Once the catheter is in place, your physician will inject x-ray dye through the catheter. Cineangiography, a type of move x-ray, will provide clear pictures of your arteries so that your doctor can evaluate for any problems. Once the physician has obtained adequate pictures and it is determined that no invasive therapy is required at that time, you will be transferred to the recovery area where the introducer sheath will be removed. Due to the catheter being in an artery, you will be required to lie flat from anywhere from two to 6 hours, once the catheter is removed. Once the groin or wrist site is deemed stable and vital signs (blood pressure, heart rate, and respirations) are at baseline, most patients are allowed to go home that same evening. If your procedure was performed in the afternoon, you may be required to stay in the hospital over night. For those that require invasive therapeutic interventions, such as stent placement, an overnight hospital stay is required. You will need someone to drive you home. You will be asked to monitor your groin or wrist site for any swelling, tenderness, bruising, or bleeding, which would require immediate notification to your physician. You will be scheduled for a follow-up visit with your physician within one to two weeks. If you experienced no complications during your angiography and no therapeutic intervention was required, many can return to work and normal activities within 48 hours. The procedure takes approximately two to three hours for preparation and test. However, plan to be at the hospital a full day, and occasionally over night.
Preparation: If your procedure is schedule in the morning, you will be asked not to eat or drink anything after midnight. If your procedure is scheduled in the afternoon, you will be asked not to eat or drink anything for four hours prior to testing. Patients are instructed to take their cardiac medications the morning of the procedure with a few sips of water. It is very important that you take your aspirin the morning of the procedure and Plavix (Effient / Brilinta) if you are prescribed Plavix. If you are on Coumadin, you will be instructed to hold your Coumadin for five days prior to your procedure. If you are an insulin-dependent diabetic and your procedure is before noon, take only half of your morning dose with juice. If your procedure is after noon, take the whole dose with a light breakfast. Glucophage should be held the day of the procedure and will be held for 48 hours after the procedure due to potential interaction with the dye. Other oral diabetic medications, such as Micronase and Glucotrol, should be held the day of the procedure. It is always best that you review all of your medications with your cardiologist prior to the procedure. It is essential that you notify your physician of any allergies to shellfish, iodine, or IV dye. Lab testing is usually required within one week of the procedure.
Location: Angiography is performed at the hospital.