A1. An Angiogram is a way of showing up blood vessels on a special X-ray machine. Using a fluid called ‘contrast medium’ to outline the insides of the vessels, a picture is produced, which is rather like a road map of the arteries or veins.

Q2. Why do I need an Angiogram?

A2. Your doctors have detected a problem in part of your circulation. You may already have had a Doppler Ultrasound test to show the site and severity of the problem. An angiogram will show the problem area in more detail.

Q3. Who has made this decision?

A3. Your doctors will have discussed your situation with the doctor responsible for performing your angiogram, the “interventional radiologist” (or x-ray doctor). You will have been asked to sign a consent form. You will also be given the opportunity to discuss the various types of treatment because your full and informed consent has to be given prior to treatment. If you do not want this test, the procedure will be taken no further.

Q4. What preparation will I need?

A4. Printed instructions will be given to you with your appointment details. You may eat a light meal up to 2 hours prior to the procedure and drink normally. On admission to the Ward you will be asked to put on a hospital gown and your blood pressure and pulses will be checked. As the Angiogram is usually done through the artery in the groin (the femoral artery) you may be asked to shave the skin in this area.

It is very important that you inform the nursing and medical staff about all allergies and medications. If you have had reactions to contrast medium, the dye used for kidney X-Rays (IVPs) and for CT scanning, then you must also tell your doctor about this.

Q5. If I am Diabetic, does this change anything?

Diabetic patients

A5. Yes. If you are diabetic and take insulin, you may need a drip to keep your blood sugars controlled. This will be discussed with you on the ward prior to the procedure. Please ring the appropriate helpline telephone number, at the hospital you are attending, as above and speak to a member of staff, who will be able to advise you. (see next question also and the 'Diabetic Protocol for further information).

Q6. I take Metformin (Glucophage, Avandamet) Tablets. Does this change anything?

A6. Yes - Metformin (Glucophage, Avandamet) is most commonly taken by diabetic patients to control blood sugar, but occasionally is taken for other conditions.

If you are taking Metformin, your preparation for the procedure may change. Please ring the helpline telephone number, as above, at the hospital you are attending and speak to a member of staff, who will be able to advise you.

Q7. What happens during Angiography and how is it performed?

A7.

Monitoring devices will be attached to your chest and one finger. A blood pressure cuff will be put on your arm. After the radiologist has checked the pulses in your groins, the nurse will clean the skin in this area with antiseptic fluid and cover the rest of your body with a drape. Local anaesthetic will be injected into the tissues around the artery and when the skin in this area is completely 'numb', a needle will be inserted into the artery through a tiny nick in the skin.
A guide wire is passed through this needle and the needle is then removed. The catheter (a thin tube) can then be threaded over the wire into the artery. The catheter is then placed in the aorta (the large artery supplying the internal organs and the arms and legs). An injection of contrast medium is given through the catheter and will travel through the circulation in your abdomen and legs while the X-Ray machine records the angiogram pictures.

Local Anaesthetic

Your radiologist will ask you to keep quite still while the injections are given.
You may notice a warm tingling feeling as the anaesthetic begins to take effect.
If you are not having sedation, you will remain alert and aware of your surroundings.Your procedure will only go ahead when you and your radiologist are sure that the area is numb
Your radiologist is always near to you and you can speak to him/her whenever you want to.

Q8. Will I feel anything during the Angiogram?

A8. The initial injection of local anaesthetic may cause slight discomfort. During the angiogram pictures the contrast medium is usually injected through a special syringe pump and this may cause a warm sensation all over along with a feeling of ‘passing water’. This is due to the circulation of the contrast medium around your body and is nothing to worry about.

Q9. How long will it take?

A9. This varies according to the complexity of the test but expect to spend anything from 30 minutes to 1 hour in the x-ray department.

Q10. What happens afterwards?

A10. The radiologist will remove the catheter and press on the puncture site in your groin. You will be taken back to the ward on a trolley. Nurses on the ward will carry out routine observations, such as taking your pulse and blood pressure. They will also check for bleeding or swelling in the groin. You will generally stay in bed for four hours. If the puncture site is satisfactory when you get up you may go home. You will be unable to drive yourself and a lift must be arranged. At home it is necessary for you to have someone to look after you overnight. You should rest as much as possible for the rest of the day and do not take any strenuous exercise for two days. You should however be encouraged to walk the following day.

Q11. What are the risks or complications?

A11. The most common complication is the development of a deep bruise called a haematoma, at the puncture site. In less than 3% of cases a blood transfusion is needed. Very rarely a small operation is required to seal the hole in the artery with a stitch.

Q12. What happens if the groin starts to swell and bleed when I get home?

A12. You should apply firm pressure just above the puncture site in your groin for 10-15 minutes. Telephone the hospital switchboard, (0191) 233 6161, and ask them to contact the on call surgeon who will then advise you.

Q13. What happens about the results?

A13. Following your examination a report will be sent to the consultant who asked for the test to be done. He will arrange to see you in the clinic.

Q14. I need an ambulance. Do you arrange one?

A14. If you need an ambulance, you must ask your General Practitioner’s surgery to arrange one. You will need to give them three working days notice. Please inform the department if you are arriving by ambulance as we will arrange your appointment time to fit with ambulance arrivals.

Q15. What if I have any comments, questions or suggestions?

A15. Should you have any suggestions or concerns, please make these known to the person conducting your examination, or by letter addressed to the hospital you are attending, as below:

(Monday – Friday: 9.00 – 5.00)

The Departmental Manager

Main Xray Department

Freeman Hospital, High Heaton

Newcastle upon Tyne

NE7 7DN

Tel (0191) 223 1012

The Departmental Manager
Leazes Wing X-ray Department
Royal Victoria Infirmary
Richardson Road
NE1 4LP

Tel: (0191) 282 5624

All Newcastle Hospitals Switchboard Tel: (0191) 233 6161

If you need to turn to someone for on-the-spot help, advice and support, please contact the Patient Advice and Liaison Service (PALS) on:

Freephone 0800-032-02-02

Due to the transformations of the Newcastle Hospitals, please see ' Patient and Visitor Guides' to check map details for updates.

Alternatively, please see map details on how to get to the new Victoria Wing, RVI.

All patient information is available in large print size for people with visual impairments or partial vision. Please click on the link above, 'large print size' to view and print the document or alternatively, please click on the large 'A' at the top of the screen to read this information on-line.

Produced by: Dr J Rose, Clinical Directorate of Radiology
Reviewed: November 2009
Next Review: November 2012