Vascular
and Interventional Radiology (Angiography)
Information
for patients
The vascular and interventional radiology division of
the department of radiology performs specialized tests to look
at and treat abnormalities in blood vessels. Many such abnormalities
are treated by placing metal stents in the blood vessels. Other
areas of the body that are also treated include the liver, stomach
and spine. All procedure are performed by board-certified radiologists
with subspecialty training in this area.
• About our division
• Frequently asked questions
• How to prepare for your exam
About
Vascular and Interventional Radiology
An
angiogram is an x-ray picture of your blood vessels obtained by
injecting contrast or "dye" into the vessel using a
catheter. The catheter is introduced into the artery by needle
access with local anesthesia, usually in the upper leg. There
are many types of angiograms. Depending on your problem, we may
be looking at the blood vessels in your legs, abdomen, chest,
neck, head, or arms. Regardless of the actual vessels being studied,
most angiograms are performed in a similar fashion.
Procedures performed in the department include:
• Renal arteriography (study of the blood vessels to the
kidneys) and angioplasty or stent placement
• Diagnostic arteriography of lower extremities (legs) and
angioplasty or stent placement
• Diagnostic carotid arteriography (arteries in the neck
that supply the brain)
• Diagnostic and therapeutic cerebral arteriography (arteries
in the brain)
• Diagnostic arteriography of lower extremities (legs)
• Implantable port placement
• Percutaneous placement of gastric and jejunal feeding
tubes
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Frequently
Asked Questions
•
Who
performs angiograms?
At Columbia Memorial Hospital, all angiograms are performed by
board-certified radiologists who have completed subspecialty training
in vascular and interventional radiology.
•
What
time do I show up at the hospital?
If you are to be admitted to the hospital, arrive at the admitting
area at 7 a.m. If you are not to be admitted, your referring physician’s
office should have told you what time to arrive at our ambulatory
surgery department for your appointment. If there are still questions,
please phone us at 518.697.3085
•
What
happens after I arrive at the Angiography department?
You will be interviewed by a nurse in the prep and holding unit.
He/she will ask questions about your medical history. Some people
find it helpful to bring along a friend or family member to help
remember details of their medical history. A list of medications
and their doses is important. The nurse will start an intravenous
line in your arm or hand. This will allow us to give you fluid
and anesthetic medication.
A
physician will also speak with you in the prep and holding unit.
He/She will perform a physical examination, ask you questions
and explain the angiography procedure in detail. The risks and
benefits of the procedure will be reviewed as well as possible
alternative therapies. After all of your questions have been answered,
you will be asked to sign a consent form, a statement that you
agree to have the angiographic procedure performed. You will then
be brought into the procedure room.
•
Who
will be in the procedure room?
During your procedure, you will hear the voices of many people.
The radiologist will be performing the actual procedure. Also
in the room will be a specially trained radiology technologist
who will run the x-ray equipment. There will be a nurse in the
room at all times. The nurse will place basic monitoring equipment
on you and administer the intravenous sedative. During the procedure,
the nurse will speak to you frequently and answer any questions
and take care of any concerns you may have.
•
What
happens during the procedure?
Usually, the catheter is introduced into a blood vessel in the
upper leg. Occasionally, we will use a vessel in the arm. The
skin is cleansed with iodine soap and a sterile blanket is placed
over you. We then use a tiny needle to numb the skin with lidocaine
(a drug that resembles novocaine used by dentists). You may feel
a mild burning when we inject the lidocaine medicine, but whatever
burns will be numb in just a few seconds. After this, you shouldn’t
feel any discomfort.
We
then enter the blood vessel near the groin with a small needle
through which we thread a catheter. A catheter is a very thin
tube that is the size of a piece of spaghetti. Using the x-ray
machine, the catheter is advanced into the blood vessel to be
studied.
Once
the catheter is positioned, we inject x-ray contrast and obtain
x-rays. Most patients don’t feel the contrast, others report
a warm feeling when we inject it. The average time you will be
on the x-ray table for a diagnostic procedure is about an hour
and a half.
•
What
happens after the procedure?
After the study is completed, you will be brought back to the
recovery room. The catheter is removed and we put pressure on
the site to prevent a large bruise or hematoma from forming. After
15 minutes of compression, it is very important that you lay flat
with your legs straight for up to six hours to allow the blood
vessel to heal. Once the effects of sedative medications have
worn off, you will be able to drink clear liquids, then eat a
meal.
Patients
being admitted to the hospital for overnight stay will be transferred
to their room. Patients going home will remain in the recovery
room for up to six hours, then discharged to home with written
and oral instructions. Phone numbers will be provided for 24-hour-a-day
access to an interventional radiologist should you have any questions.
You
will be unable to drive yourself home, so please make arrangements
for a ride home.
•
How
will I get the results of the exam?
After the scan is finished, one of our board-certified radiologists
will interpret the study and send a report to your doctor within
24 hours.
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Preparing
for the Exam
1. Inform the doctor ordering the test if you are taking any medications
that thin the blood. This includes Coumadin, Plavix and Lovenox.
If you take an aspirin a day, that is not a problem. If you are
taking a medication that thins the blood and your doctor hasn’t
advised you to stop taking it prior to the procedure, please call
us at 518.697.3085.
2.
If you have had an allergic reaction to x-ray "contrast"
or "dye" in the past, call us at 518.697.3085.
3.
Don’t eat anything after midnight the night before your
scheduled angiogram. Medications may be taken with a sip of water.
4.
If you are taking any medications regularly, please bring either
the medications themselves or a list of these medications and
their doses with you to the hospital on the morning of the procedure.
5.
If you take insulin, only take half of your regular morning dose
on the day of the procedure. If you take oral hypoglycemic agents,
do not take your dose on the day of the test.
For
more information about vascular and interventional radiology at
Columbia Memorial Hospital, call 518.697.3085.
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