• If you are an outpatient, you will need to come to the hospital at least 2 hours before your appointment for admission.
• No eating for at least seven hours before the procedure. You may drink clear fluids.
• Mostly you can continue with your current prescribed medicines. If you are a diabetic, ask your doctor about modifying your insulin dose for the day of the procedure. Certain oral medication for diabetes may have to be discontinued for 2 days.
• If you are taking a blood thinner, you must tell your doctor when the appointment is made so that it can be stopped at least 3-5 days prior to the procedure. Bring all medications with you.
• If you are allergic to contrast media (x-ray dye) or iodine or seafood please let your doctor know so that if necessary, the doctor can plan your pre-medications prior to the procedure.
• Blood tests are usually done the day before your procedure.
• On the day of the procedure, an intravenous line will be placed in one of your veins. This line will be used to give you fluids and medicines during the procedure and will stay in place until after your examination is completed.
• You are required to remove your jewelry and any dentures prior to coming to the department.

Catheter Insertion

Skin will be washed at the area where the catheter will be inserted. This is usually at the groin or on the upper arm. A local anaesthesia will be given to numb the skin and deeper tissues. A tiny nick in the skin may be made and the catheter will be introduced into the artery.

Contrast Injection

When the catheter is in the correct position, contrast will be injected through it while x-ray pictures are taken. You may feel warm for a few seconds when the contrast is injected. In most cases, several contract injections and several sets of x-ray are needed to complete the examination.

Angioplasty

Depending on the results of the angiogram, angioplasty, stent placement, or lytic therapy may be performed.

If the angiogram shows an area of narrowing, an angioplasty may be performed in an attempt to open up the area. This involves the insertion of a special tube, which has a tiny deflated balloon. The balloon is positioned at the site of the blockage and is then inflated. Following an angioplasty, if there still is not enough blood flow through the area of narrowing, a metal mesh tube (stent) may be placed at the site. The stent will widen the vessel and improve the blood flow.

If the arteriogram shows that a blood clot is blocking one of your vessels, a special drug may be given to dissolve the clot. This is known as lytic therapy. This therapy may take 24 hours or more and may require that you be admitted to the Intensive Care Unit for monitoring while this drug is being given. Additional angiogram x·ray pictures may be taken to determine the progress of the dissolving blood clot.

Catheter removal

After the examination the catheter is removed. Pressure is applied at the site of the catheter insertion for about 10 minutes to 20 minutes. The pressure will stop the bleeding.

• You will be transported back to your hospital room.
• You may feel slightly groggy due to the slight sedation given.
• The catheter insertion site may be bruised and sore. If the sheath was inserted into your arm or wrist, it will be removed and the site will be bandaged. If the catheter was inserted into your groin, you may need to lie in bed with your legs straight for several hours.
• During this time, your catheter site will be checked at regular intervals for bleeding or swelling. Your blood pressure and heart rate will be monitored.
• You may usually return home the same day or the next day.

• Resume your routine medicine, relax and take it easy for 24 hours.
• Drink plenty of fluids and resume your regular diet.
• Keep a bandage on the catheter insertion site for a day.
• Strictly avoid any strenuous exercise for at least 12 hours.

• You start to bleed where the catheter was inserted. When this happens, lie down flat and apply pressure on the bleeding area.
• There is a change in colour or temperature of the area where the catheter was inserted.
• There is a numbness, coolness or change in colour of the arm or leg where the catheter was inserted.

BENEFITS

• Angiography can give your doctors exact information about your arteries and help them plan the best treatment for you.
• Angioplasty can open your blocked or narrowed artery, restore blood flow to your tissues and relieve your symptoms without the need for surgery.

RISKS

With modern techniques, angiography and angioplasty are safe and complications are infrequent. However, the following risks are involved:

• Catheter in the artery may damage the artery and cause bleeding.
• Angioplasty may sometimes result in damage to the artery which may necessitate surgery to repair or bypass the vessel.
• You may be allergic to the contrast injection.