Angiography

For a planned angiography to begin, it is likely required to have an initial discussion on the health of the patient. The discussion shall include topics such as medical history of the patient, whether the patient has any allergies or if the patient is on any medication currently.

Some standard tests shall be performed, such as:

• Physical examination
• Blood tests to check the working condition of the organs, such as kidneys or liver

In some cases, sedatives are used to help in relaxing. If so, is suggested by the doctor, the patient shall be asked not to eat for four hours before undergoing the procedure.

• The angiography procedure is carried out by using local anaesthetic in the catheter inserting area to make it numb.
• The next process involves insertion of an intravenous (IV) line into the arm vein of the patient. Through this IV line, sedatives or any other medication will be injected.
• Electrodes will be placed on the patient’s chest to monitor heartbeat. A blood pressure monitor shall be connected to the patient’s arm.
• Sheath, a small plastic tube shall be placed into one of the arteries of the patient.
• Through the sheath, a catheter is inserted into the examined arteries.
• To guide the catheter to the right place, X-rays are used, which provide an image on the monitor. Post reaching the right place the contrast agent is injected through the catheter. Now, to create a map of the arteries a series of X-rays shall be taken.
• This is not a painful procedure. However, the patient might feel a slightly warm or a mild burning sensation, due to the contrast agent moving in the blood vessels.
• The procedure might take 30 minutes to two hours for its completion, depending on the complexity of the case and what the radiologist finds.
• In some conditions, other procedures, such as angioplasty can also be carried out at the same time, which includes inserting a balloon or a small tube termed a stent through the catheter to open a narrowed artery.

• Post procedure, the catheter is removed. Manual pressure, a clamp or a plug is then used to close the incision.
• After angiography, the patient will be moved to a recovery ward. There, for a few hours, the patient will be asked to lie still, in order to prevent bleeding in the area where the incision was performed.
• Mostly, patients recover enough to leave the hospital on the same day of the procedure.
• Though, in some cases the patient might require to stay overnight for observation. The patients can consume food and water as soon as they feel ready to.
• Shortly after the angiography is performed, the cardiologist or the radiologist shall be able to discuss on the results of the procedure depending on the outcome discovered.

Minor complications can be experienced after an angiography, but often serious complications are rarely found. Minor complications can be the following:

• Bruising or bleeding in the area where the incision was performed
• Infection in the area of incision
• Mild or moderate allergic reactions due to the contrast agent

Serious complications can be the following:

• Temporary kidney damage
• Heart attack
• Stroke
• Damaged blood vessel (which might require further surgery)
• A life-threatening allergic reaction due to the contrast agent (anaphylaxis)

Note: The serious complications mentioned rarely occur. To term in numbers, we can say that a stroke is experienced by an estimated 1 in 1,000 people due to angiography, and maybe 1 in 50,000 to 150,000 shall experience anaphylaxis.

The process of angiography is recommended only when the benefit of undergoing the procedure is considered to be exceeding any potential risk.