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Angiogram/Arteriogram

An angiogram or arteriogram is an X-ray test that uses an injection of dye (or contrast) to examine blood vessels of the head, neck, arms, legs or other organs of the body. The tests identify the area and extent of any artery blockage or narrowing. The contrast solution allows the blood vessels to be seen more clearly.

The procedure involves mild discomfort and takes between one and two hours to complete.

Before the Test
Your doctor will give you specific instructions explaining where and when to register for your test.

• Do not eat solid food for at least six hours before the test.
• You may have clear liquids early in the morning of the test.
• Needed medications may be taken with sips of water.

Day of the Test

Arriving at the Hospital

Preparing for the Test
The doctor will explain the test and discuss the risks involved. After the doctor has answered your questions, you will be asked to give your written consent for the procedure.

• The doctor will perform a brief exam and ask you questions about your medical history. Tell the doctor about any allergies or if you have ever had an unusual reaction to iodine or contrast solution.
• You will be given a hospital gown to wear. You will wear only a hospital gown, without underwear, pajamas or a robe of any kind. You will be asked to remove your watch, glasses, dentures (or bridgework), all jewelry and hairpins. Please give all valuable items to your family or send them to the cashier's office before the test for safekeeping.
• You will be asked to empty your bladder.
• The nurse will check your temperature, pulse, respiration and blood pressure, and will answer any questions.
• The doctor may order medications for you to take just before you leave for the test. This will help you relax before and during the test. This medication may even make you feel drowsy but usually you will be awake and comfortable during the test.
• An intravenous (IV) line will be started.
• If the nurse gives you medication, you are to remain in bed until it is time for the test. For your safety, the side rails will be up. When the patient escort arrives, you will be helped onto a cart and given a blanket to keep you warm. Your family or visitors may wait either in your room or in the waiting areas near the elevators on each floor.

During the Test

• The doctor will select the site to puncture the skin. The femoral artery, located in your groin, is used most often. Other sites, such as the brachial artery located in the bend of the elbow, may also be used instead. The area around the puncture site will be shaved and cleansed with a special soap that may feel cold. A local anesthetic (similar to novocaine) will be used to numb the area. When it is numb, a puncture will be made and the doctor will insert a catheter. This catheter is a long, thin, flexible tube that can be guided to a certain position. The catheter placement is not usually painful. You may feel pressure and mild discomfort at the puncture site. If needed, added injections of local anesthetic will be given.
• When the catheter is in the proper position, the contrast is injected into the catheter and carried through the blood vessels. As the contrast is injected, you may feel a sudden warm or hot sensation. This will only last a few seconds. Once the contrast solution is injected, a series of X-rays will be taken. When all X-rays have been taken, the catheter will be removed. Firm pressure will be placed over the puncture site for at least ten to fifteen minutes. This completes the test.

After the Test

• You are to remain still for at least six to eight hours. During this period, you must use a urinal or bedpan. The nurse will help you if needed. It is very important to keep your leg or arm straight. If the femoral artery in the groin was used, you will need to lay flat in bed. The nurse will check your blood pressure, temperature, pulse, along with the puncture site frequently. The pulse in the leg or arm used for the test will be checked and compared to your other leg or arm.
• An ice pack may be placed over the site to prevent swelling and relieve discomfort.
• Do not eat any solid foods until okayed by your doctor. You will be asked to drink plenty of fluids. Let the nurse know if you prefer something special to drink so it can be ordered from the dietary department. You may keep the IV until the next morning so that you can receive added fluids. This will help to "flush out" the contrast used during the test. Notify the nurse immediately if you should notice any of the following symptoms:
• swelling at the puncture site
• bleeding or bruising at the puncture site
• numbness, tingling, pain, or any change in normal sensation in your arm or leg
• difficulty moving your fingers, hands, feet or legs
• changes in vision
• difficult speaking or slurred speech

Instructions

Diet
You may resume your regular diet at discharge. You should drink at least six eight-ounce glasses of water over the next 24 hours. Water helps to clear the dye used during the procedure from your body (no alcohol for 24 hours).

Activity
On the day of discharge, limit your activities. No physical exercise or heavy lifting (greater than 10 pounds) for the next three days is allowed. Consult your own doctor before resuming strenuous physical activity. Do not drive for 24 hours after the procedure. You may resume all other daily activities 24 hours after the test. This includes normal social activities.

Wound Site/Bleeding
A small bruise may be present. If you notice any bleeding from the puncture wound, lie flat and apply firm pressure just above the puncture site. Hold pressure for 15 minutes. You may use a clean cloth or tissue to apply pressure. If possible, have another person apply the pressure. You should lie flat for about one hour before getting up and walking. Notify your doctor if this occurs. If bleeding persists for more than 15 minutes, you should be taken to the nearest emergency room for evaluation.

Sudden increase in swelling of the area around the puncture site and continuous profuse blood streaming from the site are signs could indicate that the puncture of the artery has reopened and that there is active bleeding from the artery. This would be rare, but is an emergency needing immediate medical attention. Immediately apply hard pressure above the wound and call 911.

Notify your doctor if the following occurs:

• Numbness or tingling in the arm or leg
• Difficulty moving your fingers, toes, feet or legs
• Discoloration and/or coolness of the hand or foot
• Swelling at the puncture site
• Drainage/oozing from the puncture site
• Increasing area of the bruise with discoloration extending past the initial puncture site

Your doctor will discuss the results of this test with you. If you have any questions or concerns, please ask your doctor or nurse.

Review Date: 01/05