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This is an investigation where a special contrast "dye" is delivered to the arteries "usually directly through a needle in the groin". The contrast is then followed by the X-ray machine as it travels inside the arteries. Any narrowing or blockage of the arteries can be accurately demonstrated using this technique.
Unless already an inpatient, the majority of these procedures are performed as day cases . Patients are admitted to the short stay ward on the day of the procedure. From there, patients are taken in their bed to the angiography suite. Depending on the artery of interest, one of the groin arteries will be used to deliver the contrast. To achieve this, the groin is cleaned with an antiseptic and infiltrated with a local anaesthetic. Various catheters are then introduced into the groin artery. As a standard, catheters are introduced in the opposite groin to the symptomatic leg. This can sometimes cause confusion, but the idea is to avoid damaging an already severely diseased side. During the contrast injection, the leg may feel warm and tingling. This is normal and usually subsides rapidly. Throughout the procedure, patients are reminded to lie still in order for the radiologist to obtain clear and sharp pictures.
The duration of the procedure varies according to the artery examined. At the end, all the catheters will be withdrawn and pressure will be applied on the groin for 10-15 minutes. After returning to the ward, patients are asked to lie still for two hours. The groin is then examined for signs of bleeding and if there are none, patients are discharged for outpatient follow up.
Like any interventional procedure, angiography is not without its hazards. Bleeding from the site of arterial puncture can cause large bruising around the groin. More significantly, a localised weakness in the arterial wall may lead to a "false aneurysm" formation. False aneurysms can cause continuous bleeding and invariably require surgical repair. Another possible complication is blockage of the leg arteries. This can follow injury to the arterial lining during introduction of the various catheters. This complication can be limb threatening and may require urgent surgery.
Admission: Day of Procedure Anaesthetic: Local Stay in hospital: 8-12 hours Time off work: 3-7 days First follow-up appointment: 2 weeks |
A catheter is introduced into the artery under local anaesthesia. A dye is then injected.
Dissection is where the catheter passes within the wall of the artery rather than its lumen.
Bleeding is another possible complication. |
