More information on Angiogram and Angioplasty

1. What is an angiogram?

An angiogram is a special x-ray that enables us to diagnose a blockage or narrowing in the arteries of the body, caused by atherosclerosis. This is more often known as ‘hardening of the arteries’. Hardening of the arteries is caused by a build-up of fatty deposits on the inside walls of your arteries. This narrows the hole down the middle of the artery, leaving a smaller space in which the blood may flow, hence reducing the amount of blood circulating through that section of artery. Arteries carry blood containing oxygen away from the heart, to feed the organs and tissues around the body. In order to do the test a long fine tube, called a catheter, is inserted into the artery at the groin. A special dye (x-ray contrast) is injected down the tube and x-ray pictures are taken as the solution passes along the arteries. The whole procedure will last about one hour.

2. Before the test.

Please bring all your usual medication into hospital with you. The doctor will explain the test to you and ask you to sign a consent form. It is important that you understand the test and its implications, so if you have any questions, please ask the doctor. We will want you to be as relaxed as possible for the procedure. Please tell the doctor if you have had any allergies or bad reactions to drugs or other tests, or if you have asthma, hayfever, diabetes, or any heart or kidney problems.

You will usually be admitted into hospital on the morning of your procedure. You will be asked to put on a hospital gown and will be taken to the x-ray department, where you will have the test.

3. During the procedure.

The radiologist (an x-ray doctor) will inject a local anaesthetic into the skin at your groin, to freeze the area. You may still feel some sensation such as pressure, if you feel any pain throughout the procedure inform the radiologist. You will be asked to lie as still as you can. The catheter is then inserted into the artery at the groin, and using x-rays to help, the radiologist manipulates the catheter into the correct position. X-ray pictures are taken whilst the dye is injected down the catheter into the arteries. Sometimes the injection may cause a hot feeling for a short while or the feeling that you have passed urine. When the x-rays are completed, the catheter is removed and pressure will be applied to the groin for about ten minutes to minimise any bruising.

4. What is an angioplasty?

If it is possible, the radiologist may proceed on to an angioplasty. This is a procedure in which a small balloon on the end of the catheter is blown up to re-open a narrowed or blocked artery. This technique means that surgery may be avoided in many cases. In order to perform the angioplasty a larger catheter is used, which slightly increases the risk of bleeding afterwards. You may feel the doctor changing and moving catheters in and out of your groin artery. Although this is sometimes slightly uncomfortable, it should not be painful. Sometimes, it will be necessary to insert a special device called a stent to keep the artery open. This is just a small metal cage that expands in your artery to keep the vessel open and allow more blood to flow through.

5. Afterwards.

You will be taken back to the ward and asked to remain lying flat for 4 hours so your groin does not start to bleed. It is important that you do not try to sit up or get out of bed. The nurses will check your groin, blood pressure and feet regularly.

You will normally be allowed to go home the next day and will be seen in the vascular outpatient clinic to assess the success of the procedure and decide on any further treatment needed if you were not suitable for an angioplasty.

6. Are there any side effects?

Some degree of bruising is quite common and this normally disappears in a few days. Serious bleeding is very rare. Unfortunately, in about 10% of cases, angioplasty is not successful and other treatments will need to be considered. In addition, even where angioplasty has been successful, there is a risk that the area in the artery will become narrowed again. After one year, about 20% of arteries will have re-narrowed. In some cases, it may be possible to repeat the angioplasty at that time. Very rarely, if angioplasty is unsuccessful, the circulation may actually worsen. If this is a particular risk in your case, your surgeon and / or radiologist will discuss the risks with you.

7. What can I do to help?

If you are a smoker, you must make a sincere and determined effort to stop completely. Continued smoking will cause further damage to your arteries and increase the risk of the artery re-narrowing, as well as your chance of having a heart attack or stroke. General health measures such as reducing weight, a low fat diet and regular exercise are also important.

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