Angiogram

What is an angiogram?

An angiogram is an X-ray picture of blood vessels. Your healthcare provider will put a very thin, flexible tube called a catheter into a blood vessel. A contrast dye may be used to see the blood vessels more clearly. The dye can be seen on X-rays and helps your provider check the inside of a blood vessel to see if it is narrowed, leaking, misshapen, enlarged, or blocked.

When is it used?

Angiograms are done to check for blood vessels that are narrowed or blocked or have other problems. For example, your healthcare provider can see how much and where an artery is blocked. The results can help your provider see if you need treatment to widen an artery, remove a blockage, or bypass an artery.

Sometimes other tests, such as magnetic resonance angiography (MRA) or computerized tomography (CT scan), may be done to look at the blood vessels. These tests do not require putting a catheter into blood vessels.

What are the most common kinds of angiograms?

• Carotid angiogram. This test looks at the carotid arteries. The carotid arteries travel up each side of the neck. They bring blood to the brain. An angiogram of the carotid arteries can help your provider check for narrowing or blockage of the carotid arteries. Problems with these arteries can increase your risk for stroke.
• Cerebral angiogram. This test checks blood vessels in the brain.
• Coronary angiogram. A coronary angiogram looks at the arteries that bring blood to the heart muscle. Problems with these arteries can increase your risk for a heart attack.
• Aortic angiogram. With an aortic angiogram, your provider can look at the aorta, which is the large artery that goes from the heart to the rest of the body. An angiogram of the aorta can show if it is blocked or if there is an aneurysm (a weak, bulging area).
• Aortofemoral angiogram. This test checks the arteries to the legs. Narrowing of these arteries may cause pain when you walk.
• Renal angiogram. This type of angiogram shows the blood vessels that carry blood to the kidneys.

How do I prepare for this test?

Before the test, your healthcare provider will want to know what medicines you are taking. If you are taking daily aspirin for a medical condition, ask your provider if you need to stop taking it before your test.

Talk with your healthcare provider about what medicines you should take before the test. Your provider may prescribe medicine to prevent blood clots from forming during the test.

Tell your provider if you have had any kidney problems or reactions to iodine-containing foods, such as seafood, or chemicals, such as X-ray contrast dye.

Follow the instructions your healthcare provider gives you. Eat a light meal the night before the test. You may be asked not to eat or drink anything for 12 hours before the test. If you have diabetes, your provider may give you special instructions about your diabetic medicine.

Arrange for someone to drive you home after the test.

What happens during the test?

The test is usually done in the hospital.

Before the test you will be given medicine to help you relax, but you will be awake during the test. You will also be given a shot of anesthetic to numb the area where the catheter will be inserted.

Your healthcare provider will put the catheter through the skin and into a blood vessel in your groin or arm. The catheter will be passed though a blood vessel to the artery being checked. You will not feel the catheter as it passes through your blood vessels. Dye will be put into the artery. Right after the injection of dye you may feel a warm or hot flush spreading over all or part of your body. This warm flush lasts only a few seconds. Sometimes the dye may make you feel like you have to urinate or have a bowel movement. This feeling also lasts only a few seconds.

X-rays are taken while the dye moves through your artery. Sometimes the X-rays are taken so fast that they make a movie of the dye moving through the artery. The X-rays will show where the artery is blocked or narrowed and how much blockage, narrowing, or deformity there is.

At the end of the test, your healthcare provider will remove the catheter and put pressure on the area where the catheter was inserted (the puncture site) to control any bleeding. The test will take about an hour and may be an outpatient procedure.

What happens after the test?

After the test you may stay in an observation area for at least a few hours to make sure the puncture site is not bleeding. Avoid any strenuous activity for the rest of the day to prevent bleeding. You may have a bruise near the puncture site and be uncomfortable for a few days.

Ask your healthcare provider how to take care of yourself at home. Ask about what symptoms to watch for, and what precautions you should take. Ask how and when you should expect to hear your test results. Make sure you know when you should come back for a checkup.

What are the benefits of this test?

Angiograms can find problems with blood vessels. They help your provider know what treatment may be best for you.

What are the risks of this test?

Complications from this test are rare. Possible risks include:

• You may have an allergic reaction to the dye. An allergic reaction may cause hives, trouble breathing, a drop in blood pressure, unconsciousness, or swelling of the skin. This reaction can be treated with medicine.
• The dye could damage the kidneys. If you have diabetes or kidney disease, you may have a higher risk for kidney damage. Your healthcare provider may want you to take medicine before and after the test to help protect your kidneys.
• The test can cause irregular heart rhythms, which might need treatment.
• You may have bleeding where the catheter was put into your blood vessel.
• A blood clot could form around the catheter when it is in an artery. The clot could block the artery.
• The catheter may damage an artery, for example, the vessel in the groin or arm where the catheter was inserted.
• In rare cases, you may have an allergic reaction to the drug used in the anesthesia.
• While not common, a heart attack or stroke might be triggered by the test.

You should ask your healthcare provider how these risks might apply to you.

When should I call my healthcare provider?

Call your provider right away if:

• The place where the catheter was put into your skin starts to bleed or swell, or it gets more painful.
• You have a fever.
• Your leg or foot is painful or unusually cool.
• You have slurred speech, balance problems, or trouble using your arm or leg.
• You start having a rash, itching, sweating, or trouble breathing.
• You have chest pain that is new or different from chest pain you have had before.

Call during office hours if:

• You have questions about the test or its result.
• You want to make another appointment.