Undergoing Arch and Carotid Angiogram or Angiography
Undergoing Arch and Carotid Angiography (Angiogram) or Arteriography (Arteriogram)
Author ID: DB X-Ray 003
Version: 8
Last review: April 2021
Expiry Date: April 2023
Introduction
This leaflet provides information about the procedure known as an angiogram (or arteriogram). It explains what is involved and the possible risks. It is not meant to replace informed discussion between you and your doctor but can act as a starting point for such a discussion. Whether you are having a pre-planned angiogram or as an emergency procedure, you should have sufficient explanation before you sign the consent form.
What is an Angiogram?
An angiogram is a procedure where x-rays are used to examine blood vessels. Normally, blood vessels do not show up on an ordinary x-ray, and a special dye called contrast medium is injected into the artery through a fine plastic tube called a catheter. X-rays are then taken immediately afterwards, producing detailed images of arteries.
Why Do I Need an Angiogram?
You may require an angiogram if there is a problem with your circulation.
Who Has Made the Decision?
The consultant in charge of your case and the radiologist doing the angiogram believe this is the next step. However, you will also have the opportunity for your opinion to be taken into account, and if, after discussion with your doctors, you do not want the procedure carried out, you can decide against it.
Who Will Be Doing the Angiogram?
A specially trained doctor called a radiologist will perform the angiogram. Radiologists have special expertise in using x-ray and scanning equipment and in interpreting the images produced.
Where Will the Procedure Take Place?
The procedure will take place in the x-ray department, in a room adapted for specialised procedures.
How Do I Prepare for an Angiogram?
- You will attend a pre-op assessment to gain more information about you, discuss medication, and answer your questions.
- On the day of the procedure, you will be asked to put on a hospital gown.
- If you have any allergies, you MUST inform your doctor.
- If you have previously reacted to intravenous contrast medium, inform your doctor.
What Happens During an Angiogram?
You will lie on the x-ray table, generally flat on your back. A nurse will monitor your blood pressure, pulse, oxygen levels, and heart rate. The radiologist will keep everything sterile and wear a theatre gown and operating gloves. The skin near the point of insertion will be cleaned with antiseptic, and the rest of your body will be covered with a theatre towel. The skin and deeper tissues over the artery will be anaesthetised with local anaesthetic, and then a needle will be inserted into the artery. Once the radiologist is satisfied with the position, a guide wire is placed through the needle into the artery. The needle is withdrawn, allowing a catheter to be placed over the wire and into the artery. The radiologist uses x-ray equipment to ensure correct positioning, then withdraws the wire. A special dye is injected through the catheter, and x-rays are taken. Once the required information is obtained, the catheter is removed, and a seal (Angioseal) is placed in the artery at the puncture site.
Will It Hurt?
Some discomfort may be felt during the injection of the local anaesthetic. After this, the procedure should not be painful. A nurse or another member of clinical staff will be nearby. As the dye passes around your body, you may feel a warm sensation.
How Long Will It Take?
The duration varies depending on the complexity of the procedure. Expect to be in the x-ray room for two hours altogether.
What Happens Afterwards?
- You will be taken back to a day-case ward on a trolley.
- Nurses will carry out routine observations to ensure there are no problems.
- You will stay flat for 30 minutes, then sit up, and 30 minutes later, you can walk about.
- The usual recovery time is 4 hours, after which you can go home.
- You MUST have someone at home with you overnight as a precaution.
Are There Any Risks?
An arch angiogram is a safe investigation. Complications are uncommon and occur in less than 1% of examinations. Most are minor and require no additional treatment. The most common problem is a bruise at the puncture site. Other rare complications include damage to the blood vessel wall or blockage. If a selective carotid angiogram is performed, there is a small additional risk of a mini-stroke or TIA. This must be balanced against the reason for the angiogram, which is to assess the severity of narrowing in your neck vessels.
Medication Instructions
You should continue taking your medication unless they belong to the following groups:
- Diuretics or "water tablets"
- Anticoagulants (warfarin)
- Diabetic medication (insulin or tablets)
Instructions will be provided at your pre-op appointment.
Contact
If you have any of the conditions mentioned or need further information, contact the x-ray department.
Be contacted directly on (01942) 778720, (01942) 822397 or via the hospital switchboard on (01942) 244000 and ask for the X-Ray Department.
Acknowledgements
Wrightington, Wigan and Leigh NHS Foundation Trust acknowledges The Royal College of Radiologists as the original authors of this leaflet. © The Royal College of Radiologists, May 2008. Permission is granted to modify and/or reproduce this leaflet for purposes relating to the improvement of healthcare, provided that the source is acknowledged and that none of the material is used for commercial gain. The material may not be used for any other purpose without prior consent from The Royal College of Radiologists.
Legal Notice
Please remember that this leaflet is intended as general information only. It is not definitive, and The Royal College of Radiologists and the British Society of Interventional Radiology cannot accept any legal liability arising from its use. We aim to make the information as up to date and accurate as possible, but please be warned that it is always subject to change. Please therefore always check specific advice on the procedure or any concerns you may have with your doctor.
This leaflet has been prepared by the British Society of Interventional Radiology (BSIR) and the Clinical Radiology Patients’ Liaison Group (CRPLG) of The Royal College of Radiologists. Board of the Faculty of Clinical Radiology.
Comments, Compliments or Complaints
The Patient Relations/Patient Advice and Liaison Service (PALS) Department provides confidential on-the-spot advice, information, and support to patients, relatives, friends, and carers.
Contact Us
Tel: 01942 822376 (Monday to Friday 9am to 4pm)
The Patient Relations/PALS Manager
Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust
Royal Albert Edward Infirmary
Wigan Lane
Wigan WN1 2NN
Ask 3 Questions
Become more involved in decisions about your healthcare. You may be asked to make choices about your treatment. To begin with, try to make sure you get the answers to three key questions:
- What are my options?
- What are the pros and cons of each option for me?
- How do I get support to help me make a decision that is right for me?
How We Use Your Information
For details on how we collect, use and store the information we hold about you, please take a look at our “how we use your information” leaflet which can be found on the Trust website: https://www.wwl.nhs.uk
This leaflet is also available in audio, large print, Braille, and other languages upon request. For more information please ask in the department/ward.
© Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust. All rights reserved. Not to be reproduced in whole or in part without the permission of the copyright owner.
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