Angiogram

An angiogram is a special type of X-ray used to study blood vessels. A fluid called contrast dye is injected through a catheter (a flexible tube) inserted into a blood vessel, which makes it easier to study X-ray images of tissues and organs.

If the dye is inserted into an artery (a blood vessel that carries blood from the heart to the rest of the body), the procedure is sometimes called an arteriogram. If the dye is inserted into a vein, the procedure may be called a venogram.


Purpose/indications
Angiograms are used to help doctors see blood flow through blood vessels and organs. The test is used most often to examine the arteries that supply blood to the head, heart, kidneys, intestines and legs. An angiogram may be recommended for various reasons, depending on the part of the body in question.

Patient preparation
Before the procedure, you'll need lab work and an electrocardiogram (a recording of the electrical activity of the heart.) A recent electrocardiogram may be sufficient.
Be sure to tell your doctor about any food or drug allergies, including any previous reactions to contrast dye. Also list the medications you're currently taking, such as insulin, metformin (Glucophage, for example) or blood thinners.

You won't be able to eat or drink anything for about two to eight hours before the test, including coffee, tea or water, and you'll need someone to drive you home afterward.


Procedure
The angiogram will be done in an X-ray room. You'll be given medication before the procedure to help you relax, and an IV will be started.
Then the spot where the catheter will be inserted -- typically in the groin or, rarely, the arm -- will be shaved, cleaned and numbed with a local anesthetic. The doctor will make a small incision in the skin and insert the catheter. You may feel slight pressure while the catheter is being positioned.

Once the catheter is in place, the contrast dye will be injected through the catheter and X-rays will be taken. You may feel temporary warmth as the dye is injected.

The procedure usually lasts about one hour. To avoid distorting the X-rays, it's extremely important to remain still during the procedure.


Postprocedure care
After the angiogram, the catheter will be removed and pressure will be applied to the spot for a few minutes. With angiograms done from the groin, you'll be asked to lie flat and keep your hip and leg straight for four to eight hours after the procedure, usually with a weight or some type of pressure placed over the puncture site. This will allow the puncture site to begin healing and decrease the risk of complications.
A closure device may be used to close the puncture site, which often allows you to be up and moving within two to four hours (unless the angiogram was done from your groin). A small lump or bruise at the puncture site is normal. The bruise may spread down the involved leg over the next few days, and its color may change as the blood reabsorbs. This doesn't mean there's active bleeding at the site, however.

Pain medication may be given if needed, and the medical staff will periodically check the puncture site and the circulation below the puncture site, as well as your heart rate and blood pressure. You'll be encouraged to drink plenty of fluids to help flush the dye from your system and prevent dehydration. (Effects of the dye may cause you to urinate more than normal.)


Benefits
An angiogram can help doctors diagnose:
narrowing or blockages of an artery (a blood vessel that carries blood from the heart to the rest of the body)
a tumor (an abnormal tissue growth that may be benign or cancerous)
an aneurysm (a weakness in a blood vessel wall, usually an artery, that results in a balloon-like swelling)

Risks
The risk of complications is low. Possible complications include:
bleeding or bruising at the puncture site
infection
allergic reaction to the contrast dye
blood clots
damage to the affected artery
kidney failure
heart attack
stroke
Rarely, complications may be life-threatening.


Considerations
You may need special preparation if you:
are unable to cooperate
are allergic to shellfish or iodinated dye
are dehydrated
have a bleeding disorder
have kidney disease
have unstable heart disease

Pregnancy-specific information
Angiograms are not generally recommended for pregnant women.

Senior-specific information
The risk of developing cardiovascular disease increases with age, which may increase the risk of needing a coronary arteriogram. The risk for complications from the procedure may increase if you have kidney disease, severe cardiovascular disease or certain other medical conditions.