WHAT IS AN ANGIOGRAM?
Nuclear medicine uses a small amount of a radioactive substance to produce images of the body. The radioactive material is detected in the body by the scanner and then images mapping the material throughout the body are produced. These images are two- or three-dimensional and show detailed body anatomy and function. Nuclear scans allow clearer images of organ and tissue structure than traditional, non-contrast imaging.
Who should have angiography?
Your doctor might recommend angiography if you have common symptoms related to Coronary Artery Disease or related vascular conditions. Coronary Artery Disease is commonly caused by atherosclerosis, or the narrowing and hardening of arteries. Diseases caused by atherosclerosis are the most common cause of death in the United States. Atherosclerosis usually begins early in life, progressing without symptoms, as plaque narrows the artery. Yet, by the time symptoms occur, atherosclerosis is usually advanced and represents a serious health concern.
Atherosclerosis is progressive, but it’s also preventable. You may be at risk if any of the following apply to you:
- High cholesterol
- High blood pressure
- Abdominal obesity
- Not eating fruits and vegetables
- Excess alcohol intake (more than one drink for women, one or two drinks for men, per day)
- Not exercising regularly
While Coronary Artery Disease is the most common condition associated with atherosclerosis, cerebrovascular disease and peripheral arterial disease may also occur. Since atherosclerosis is so widespread and dangerous, you might ask, “Why don’t we test everyone with the best tests we have?” With advancing technology, more minimally invasive options are available - such as cardiac CTA. However, in some cases, angiography is still necessary and can be particularly useful if immediate treatment is required.
How to prepare
Because angiography is a specialized, invasive procedure, some special preparation is needed. Please follow these guidelines before your exam:
- Arrange for someone to drive you home after the procedure. Avoid driving for 24 hours after the exam.
- Discontinue any of the following medications 3 days before your procedure: Plavix, Pletal, Ticlid, Trental, Coumadin, Warfarin, Brilinta, Xarelto or Pradaxa. Discontinue Effient for 7 days before your procedure. Patients who have had a drug eluting cardiac stent within the past year should not stop Plavix or Effient.
- Discontinue any of the following medicines 24 hours before your procedure: Lovenox, Fragmin, Normiflo, Orgaran, Innohep, Arixtra, Eliquis or Iprivask.
- Take all other medications normally prior to your exam. Please take blood pressure medication the morning of your procedure. Please bring all your medications with you to your appointment. Do not hold heart or blood pressure medications.
- If you are on insulin, take half of your dose the morning of the procedure. Do not take any oral diabetic medication the morning of the exam.
- Do not eat solid foods 6 hours prior to your procedure. You may drink clear liquids until 2 hours before the procedure (no milk or creamer, no juice with pulp).
- If you have had imaging done prior to your angiogram, please bring a copy with you.
- On the morning of your procedure, please come to Premier Radiology Briarville 30 minutes prior to your appointment. We open at 7:30am.
- Inform the staff of any allergies you have.
- Please fill out and bring the documents and questionnaire about your current health status.
- Bring a copy of the order for the procedure from your referring physician.
- Bring a copy of your personal identification and health insurance information.
Download the angiography consultation and preparation form.
What to expect during an angiogram
Angiography is an exam that produces images of the vascular system to aid in diagnosis and treatment of a range of medical conditions. Before the exam, you will be given mild sedation through an IV inserted in the arm; your skin will be cleansed with antiseptic soap and numbed with local anesthetic. Then, an interventional radiologist will insert a small, tube-like camera called a catheter into an artery in the groin or arm. Once the catheter is inserted, contrast dye will be injected, which makes blood vessels visible on x-ray. The process usually takes about one to one and a half hours to complete.
Angiograms require a special dye, often called “contrast,” to produce images of the vascular system. Contrast can provide clearer images and allow better diagnostic capabilities. If you are given contrast, you might be asked not to eat or drink anything for 3-4 hours before the test. Contrast given through an IV might cause a metallic taste in the mouth, nausea and a warm flushing sensation. These sensations are normal and usually go away within a few minutes. Contrast typically does not cause symptoms; however, some mild symptoms, such as nausea, headache or itching. More complex side effects are rare; however, if you experience severe symptoms, inform your doctor immediately.
If you have kidney disease or diabetes, you should receive plenty of fluids before and after the test and be closely monitored for kidney problems. If you have diabetes or are on kidney dialysis, talk to your health care provider before the test about your risks
What if I need treatment after my angiogram?
One of the benefits of angiography is the ability to immediately treat certain conditions after visual diagnosis. Usually, if treatment is needed, an interventional radiologist will perform angioplasty. While you are still sedated, the interventional radiologist will move the catheter into an artery at the blocked vessel. A small balloon is inflated under x-ray guidance to open the artery and improve blood flow before being deflated. If angioplasty does not work, vascular stenting may be needed. After the artery is opened by the balloon, a small wire tube is inserted to maintain the opening.
Once the angioplasty or stent placement is complete, the catheter is removed. Patients are then moved to recovery and are typically able to walk within a few hours after the procedure and resume normal activity within one week. After your exam, you may need follow-up imaging, such as ultrasound, CT (computed tomography) or MRI (magnetic resonance imaging) exam.
After your procedure, please following these guidelines:
- Drink plenty of clear (nonalcoholic) liquids, at least 8 oz. every hour
- Resume your usual diet and any medications you routinely take (unless otherwise instructed by your doctor)
- For the next 12 hours, attempt to keep the leg in which the catheter was placed as straight as possible
- No driving, operating heavy machinery or making legal decisions for 24 hours following the exam
- For several days after the procedure, avoid strenuous activities including vigorous exercise, lifting objects heavier than 10 pounds or excessive bending at the waist
Our interventional radiologists offer the full spectrum of care including pre-procedure consultation, post-procedure care and when necessary, hospital admission. All patients can schedule an office visit to consult with a radiologist to discuss vascular options prior to performing any procedure. To schedule an appointment please call our Briarville office at 615.986.6411.