What is an angiogram? An angiogram is a test that uses X-ray images to view your body’s blood vessels. Some of the frequently viewed vessels include the heart (coronary), neck (carotids), kidney (renal), extremities (peripheral) and aorta.
What should I expect when I arrive?
- You will check in with the receptionist in the Heart Center on the second floor of Lakeland Medical Center in St. Joseph and be asked to fill out paperwork.
- The nurse will take you to the prep area to review your health information and answer your questions.
- In the prep area you will sign consents, change into a gown and have an IV started. The IV will allow us to give you fluids and medications as needed. You may also need lab tests done before the procedure.
- It will be necessary to remove hair with electric clippers in the area of your groin or arm where the catheter will be inserted.
What happens during the procedure?
- You will be taken into one of our procedure rooms where you will be placed on the X-ray table. You will be attached to equipment that will monitor your blood pressure, heart rate, and oxygen level.
- A nurse is present to give you medications to help you relax and to reduce any pain or discomfort you may experience.
- The physician will insert a small flexible tube called a catheter into the artery of your leg or arm. IV dye is injected and pictures will be taken. Some patients experience a warm flush feeling when the dye is injected that lasts only a few seconds.
- Through the catheter, the doctor is able to check for blockages and place a stent(s) if possible.
What happens after the procedure?
- When the procedure is completed, the next step is to remove the catheter.
- When the access site is the groin, there are two possible ways for this to happen:
- The catheter may be removed in the procedure room. A closure device may be used to control bleeding at the puncture site in the groin. You will then spend at least two hours in the Heart Center recovery room.
- If a closure device is not used, the catheter will be removed in the Heart Center recovery room. Firm pressure will then be held by hand at the procedure site for 15 to 20 minutes. Once assured there is no bleeding, a sandbag will be applied to the site. You will need to lie flat with your leg straight for four hours. This is very important to prevent any possible bleeding from the femoral artery.
- When the access site is the arm, firm pressure will be held by hand or a compression device will be used.
- The nurse will frequently check your blood pressure, pulse, and procedure site.
- You will be given clear liquids to drink at first. Your diet will slowly return to normal as you are able to tolerate it.
- If your physician has determined that you will stay overnight, you will be taken to your room when it is available.
What happens if I have a blockage? If the angiogram shows that you have a blockage in an artery, your doctor may decide to perform an angioplasty or stent placement. These procedures will allow the artery to be widened, allowing the blood to flow through easier.
- Balloon Angioplasty: A balloon-tipped catheter is placed in the blocked artery. Once in place, the balloon is inflated. This pushes the plaque against the artery wall which widens the area of blockage. The balloon is deflated and removed.
- Stenting: A stent is a flexible tube made of wire mesh which is mounted on a balloon-tipped catheter. The balloon and stent are inserted into the area of blockage and the balloon is inflated. This opens up the stent which pushes the plaque against the artery wall. The balloon is deflated and removed, however, the stent remains in place as a permanent support. If you have a stent procedure, you will stay overnight in the hospital. More information on what you need to know after your stent procedure will be provided to you.
Special considerations before your procedure:
- If your procedure is scheduled in the morning, do not eat anything after 12 midnight the night before. If your procedure is scheduled in the afternoon, you may have a light breakfast.
- Take your routine medications with a sip of water.
- If you are diabetic and take insulin in the morning, take 1/2 of your normal dose.
- If you are taking a diabetic medication called Glucovance/ Glucophage®, stop taking this drug ________days before your procedure unless otherwise directed by your physician.
- If you are on a blood thinner such as Coumadin®, stop taking this drug ______days before your procedure unless otherwise directed by your physician.
- If you are taking aspirin and/or Plavix® or Effient®, please continue unless otherwise directed by your physician.
- If you are taking a diuretic (water pill), please do not take it the day of your procedure, unless otherwise directed by your physician.
- Bring all of your medicines with you in their original container. This includes over-the-counter and herbal medicines.
- Bring your Bi-pap/C-pap machine if you have one.
- If you are scheduled for a carotid angiogram, it is important that you do not take any diuretics (water pills), as well as any blood pressure medicine on the day of your procedure.
- If you have been given a green armband, it is important to bring it with you for this procedure.
- Wear comfortable clothes.
When you go home:
- You will need to have someone drive you home, because you will not be able to drive yourself the day of the exam.
- If you live alone, you should also make arrangements for someone to stay with you the first night at home.
- For the first 24 hours after your procedure your activity will be restricted. You may be up for meals and to use the bathroom, otherwise you will lie flat or use a recliner with your legs elevated.
- You should not drive or operate machinery due to drowsiness from medication and/or potential for bleeding from the procedure site.
- Avoid bending over, squatting, and lifting over five pounds.
- You will have a dressing on the procedure site. Keep this area clean and dry and change the dressing daily for five days.
- Avoid hot tubs, tub baths, or swimming for five days after your procedure. However, you may take a shower.
- Instructions concerning your medications, activity, and follow up care will be discussed in greater detail when you are discharged home.