This overview is a sample of the type of information available to you at Griffin Hospital's Community Health Resource Center. It is not intended to replace your physician's instructions in the management of your health problems, but to better inform you about a particular illness and alert you to the availability of other materials. If you have a question about any piece of information presented in theses fact sheets, please call your physician, or stop by the Community Health Resource Center at your convenience.

ANGIOGRAPHY (Angiogram, Arteriogram)

Angiography or arteriography is a diagnostic procedure used to examine the arteries or blood vessels that supply blood to the brain, kidneys, abdomen, or legs. Usually blood vessels are difficult to see on regular x-rays. By using angiography, a special contrast dye can be injected directly into the arteries being examined. A radiologist can then see any abnormalities, injuries, or blood clots.

You will be asked not to eat or drink anything the night before the test. If you are allergic to seafood or iodine, or if you had an allergic reaction to contrast dye in the past, tell your nurse or doctor before the test begins.

Angiography is performed in the radiology department by a radiologist. Although the room may look like an operating room, and the radiologist will wear a gown and gloves, this is not a surgical procedure and you will be awake the entire time. It is Important that the test be done under sterile conditions in order to prevent infection.

When the procedure begins you will be asked to lie on your back on an x-ray table.

One of the most uncomfortable parts of this test is having to be still on such a hard surface for 30 to 60 minutes, or possibly longer. If the blood vessels in your neck (carotid arteries) are being examined, you may be asked to remove dentures, jewelry, or bobby pins before the exam begins.

When you are ready to begin, the doctor will shave and clean the skin over a large artery (the femoral artery) in your groin. (Occasionally arteries in your arms may be used instead). A local anesthetic will be injected into the skin which may sting for a few minutes before it numbs the area. Sometimes a sedative or tranquilizer may also be given, but this is usually unnecessary.

The doctor will then insert a thin tube, called a catheter, into the artery. Because of the local anesthetic, this procedure should not cause any pain. The catheter will then be threaded through the blood vessels to the area that is to be examined. The contrast medium or dye will then be injected through the catheter into the arteries, and x-rays will be taken as the dye flows through the vessels.

The amount and concentration of the dye will vary depending on which vessels are being injected. Sometimes the dye will be injected several times so that an additional series of x-rays can be taken as in the case of Digital Subtraction and Angiography (DSA).

As the dye flows through the arteries, most patients experience a warm sensation in the area where the dye is injected. If the dye is concentrated or given very quickly, it may feel very hot, but this feeling will last for only a few seconds. The dye can also cause nausea and a strange metallic taste in the mouth. These side effects will also pass very quickly. If you experience itching, hives, or difficulty breathing, tell the doctor or nurse immediately since these could be signs of an allergic reaction.

When the procedure is over, the doctor will remove the catheter and place a dressing over the insertion site. Pressure will be applied to the area for 10 to 15 minutes to prevent bleeding. When you are back in your room, your vital signs (temperature, pulse, and blood pressure) will be frequently taken for several hours and your nurse will observe your groin for signs of bleeding or bruising. Your nurse will also check your leg for color and temperature to make sure you are receiving adequate blood flow.

You will be asked to lie flat for at least the first four hours after the test, without bending your leg on the side the catheter was inserted. This allows the artery to heal and to prevent bleeding. It is alright to lie on your side with your leg straight, or to bend your other leg. It will probably be recommended that you remain flat, if possible, until the next morning.

Bleeding from the insertion site after the procedure is one of the potential risks of angiography. A rare but more serious complication is that the catheter could dislodge deposits on the inside of the vessels which could then clog arteries to the brain or heart, causing a stroke or heart attack. It is also possible that the dye could cause kidney failure in patients who have kidney disease or who have diabetes. You may be requested to drink lots of fluids after the test to help flush the dye out of your kidneys.

After the procedure, the radiologist will review the x-rays and give a written report to your doctor. The information should be available in several days.

Please note that this information is intended to give you a general overview of the topic. It is not intended to replace advice or instruction of a health professional. We recommend that you consult your physician, nurse, or qualified health professional regarding the information in this publication. © 1994 Planetree, Inc. Reproduction of this material in any form is limited to license agreement.

Planetree Health Fact Sheets are developed by Planetree, Inc., a non-profit consumer health organization, founded in 1978. The Planetree Alliance includes hospitals and libraries which, among many other patient-centered concepts, promote the importance of access to health information for patients, families, and community. For more information regarding affiliation with the international Planetree Alliance, call (203) 732-1365 or visit Planetree, Inc. at www.planetree.org.