The Angiogram Procedure – Detecting The Need For Surgery

An angiogram or angiography is a medical imaging technique through which blood vessels in the body are visualized, mainly to check for any blocks, narrowing, dilatations and structural anomalies.

This procedure is used to detect the need for angioplasty, a procedure through which narrow and hardened arteries are corrected. This is a diagnostic test that’s done after a patient exhibits atherosclerosis symptoms.

What Does The Angiogram Procedure Involve?

Through an angiogram, arteries, veins, and the four chambers of the heart are visualized by injecting radio-opaque dye (which is recognized by X-rays) into the body. Coronary (heart) angiogram, cerebral (brain) angiogram, and renal (kidneys) angiogram are the different forms of angiograms, based on the area of vasculature to be visualized.

Techniques used for angiographic visualization mainly involve:

  • X-rays
  • CT scans (Computed tomography)
  • MRI (Magnetic resonance imaging)                                                                          

Where Is An Angiogram Procedure Performed?

An angiogram is a minimally invasive technique, and it is usually performed in a cardiac catheterization laboratory by interventional radiologists or cardiologists.

Preparing For An Angiogram

Make sure that you consult your doctor for advice regarding:

  • Medications (to continue, stop, or modify the dose). More importantly, ask them for advice on aspirin and heparin.
  • Blood tests (kidney function tests, blood clotting, and bleeding time).

You will need to fast for at least 8 hours before the angiogram procedure begins. The doctors might run a prior test with the dye to make sure that you’re not allergic to it.

angiogram procedure
During an angiogram procedure, a radio-opaque dye is injected into the body.

What Happens During The Angiogram Procedure?

You will be taken to a coronary catheterization laboratory for the angiography procedure, and in order to maintain healthy circulation, the doctor will put you on intravenous fluid infusion.

Your doctor will decide the site for inserting the catheter.

Depending on the area that needs to be visualised, the doctor will choose the right blood vessel.

In more than 95% cardiac catheterizations, veins of the femoral region (groin and upper thigh) are used. The femoral artery (artery in groin-upper thigh region) is used for left heart catheterization, while the femoral vein is used for right heart catheterization.

To avoid the risk of infection, the skin over the site of insertion is shaved and cleaned before the doctor punctures the artery/vein with a large bore needle. A catheter is passed and pushed through the needle till the desired site is reached.

An X-ray machine is usually set to visualise the dye in the blood vessels, and these visualizations are projected on a video screen. The dye is then injected at the chosen site, and rapid shots of X-rays are captured as the dye flows through the blood vessel.

This way, any narrowing, blocks, or malformations in the blood vessels are highlighted with ease.

The angiogram procedure takes around 30 minutes, and after the procedure is over, the catheter is taken out and the puncture site is pressed for 10-15 minutes to prevent bleeding.

Patients are monitored for about 6 hours and may even be advised bed rest for 2-4 hours, till their vitals become stable.

Once the procedure is done, patients are advised to: 

  • Keep the limb straight and stable to avoid bleeding from puncture site
  • Avoid heavy exertion or intense physical activities for 1-2 days
  • Increase the water intake for 2 days 

Are There Any Risks Associated With Angiograms?

Some of the complications associated with the angiogram procedure are:

  • Bruise at the site of puncture (resolves by itself)
  • Allergic reactions to dye (resolved by prior checking)
  • Pain/ bleeding/ swelling near the puncture site
  • Kidney impairment (in rare cases)
  • Heart attack, stroke (in rare cases)

Can An Angiogram Help Determine The Need For An Angioplasty?

The angioplasty procedure is a surgical procedure that helps restore the lumen of blocked/ narrowed blood vessels, and an angiogram helps in revealing the sites and extent of blockage or narrowing in the arteries.

Once a patient presents with some of the atherosclerosis symptoms, doctors take the call and recommend the angiogram procedure. Once the condition has been diagnosed, further treatment measures are chosen.

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