Information for patients who require an Angiogram or Angioplasty

Transcription

1 Information for patients who require an Angiogram or Angioplasty Why do I need this Investigation? This investigation is needed for a number of different reasons You may have experienced pain in your buttocks or legs when walking. You may have had pain in your legs at rest or when lying in bed. You may have an ulcer that is not healing. This can be because the arteries (blood vessels) in your leg have become narrowed. Your arteries are normally smooth and unobstructed on the inside but they can become blocked through a process called atherosclerosis, which means hardening of the arteries. An angiogram is performed by a radiologist. It will give your doctor vital information about how your symptoms can be improved. What are the benefits of the investigation? The angiogram shows if there is any narrowing or blockages in your arteries that may be causing the symptoms you have been experiencing. An angioplasty will help to re open a narrowing or blockage and relieve any pain or discomfort you are experiencing Page 1 of 5

2 How do I know if this is a suitable procedure for me? You will need to attend the radiology pre assessment clinic to establish your general health. At this clinic you will need to have your blood pressure measured, a heart tracing performed and blood samples taken. A nurse will talk to you about the investigation. You will also be asked to give your consent for the procedure to go ahead following a detailed discussion with a radiologist or senior nurse. Can I take my medication as normal? Most medication can be taken as normal. If you are taking Metformin, Clopidogrel, Warfarin or Aspirin it is important that you let us know and we will discuss this with you at pre assessment. Are there any alternatives to the investigation? Sometimes an MRI scan can be a helpful alternative to an angiogram. An ultrasound scan can be done to examine the arteries in the leg however this is not suitable for everyone. What happens during the Investigation? Angiogram You will be admitted to hospital for this procedure. Depending on your individual circumstances this can either the day before or the day of the procedure. You will be asked to put a hospital gown on and a plastic needle will be inserted into one of your veins. You should continue to eat and drink normally but avoid fizzy drinks. The procedure is performed in the x-ray department. On entering the x-ray room, a Radiologist, Radiographer (person who ensures safe use of the x-rays) and a nurse will greet you. You will be asked to lie flat on your back on the x-ray table. During the procedure your blood pressure, oxygen levels and heart rate will be measured regularly. It is possible to perform the procedure through an artery in your groin or arm; this will be discussed with you at pre assessment. The skin over the artery will be cleaned and some local anaesthetic will be injected into the skin that has been cleaned. The local anaesthetic will make this part of your body go numb. You may then feel a little pressure as a thin catheter (tube) is placed into the artery. The position of this catheter can be seen on the x- Page 2 of 5

3 ray monitor. When it is in the correct position Contrast (x-ray dye) is injected through it and x-rays taken at the same time. This produces x-ray pictures of the inside of your arteries and will show any narrowed or blocked areas. As the Contrast enters the body, you may feel a warm sensation. It may feel as if you are passing water (urine), but rest assured this is only a feeling. This part of the procedure is called an angiogram. Angioplasty If it is possible the radiologist will now replace the catheter already in position with one that has a balloon at the end. The balloon is placed in the narrowed or blocked area. As the balloon is inflated, it pushes the disease back to the side of the artery, widening the artery allowing blood to flow more easily through it. The balloon is then deflated and removed. When the procedure is over the catheter needs to be removed and the hole in your artery sealed. This is normally done by applying pressure over the puncture hole for about 10 minutes to ensure bleeding stops. Sometimes the artery may be closed with a tiny fabric plug or metallic clip. What happens after the Investigation? You will be escorted back to the ward by a qualified nurse. You will need to lie flat for 3 hours after an angiogram and 6 hours after an angioplasty. This is to help lessen the risk of bleeding from the puncture site. If you need to use the toilet during this time, please ask for a bedpan or bottle. It is important to put pressure on your puncture site when moving, coughing, laughing or sneezing. This can be done by gently putting your hand over the area. A nurse will observe your puncture site regularly and take your blood pressure. If you feel any swelling, oozing or pain in the area of the puncture site please inform the nurse immediately. Should you find it difficult to lie flat the nurses and doctors will try to find a way to assist you in this matter, ensuring your comfort. You will be allowed to eat and drink after this procedure, although this will need to be lying flat for the recovery period. It is important to drink normally (1 glass fluid an hour whilst you are awake) after this procedure to help your kidneys excrete the Contrast from your body. Page 3 of 5

4 What complications can happen? Angiogram. The commonest complication is the development of a bruise often called a haematoma, at the puncture site. This happens in about 2 % of cases. There is a very small risk that you may be allergic to the Contrast (dye) used during the procedure and also that the Contrast may affect how well your kidneys function. As this risk varies we will need to discuss it with you at our pre assessment clinic Angioplasty The complications for angiogram apply to angioplasty as well as those listed below: There is also a 1-2% risk that during an angioplasty plaque (disease) could become dislodged or that a clot can form at the site of the angioplasty and cause your symptoms to become worse. This may require surgery to resolve. In a rare case (less than 1 in 100) this could result in the loss of a limb (amputation). How soon will I be back to normal? Many patients go home the same day but you may be in hospital overnight following the procedure. This will be discussed with you at pre assessment clinic. The doctors will only send you home when they are pleased with your progress. Be guided by how you feel, If you do have any concerns do not hesitate to contact your GP, the radiology nurse or the vascular nurse specialist on the number below. Do not drive until you are confident about controlling your vehicle and always check with your insurance company. Angioplasty does not stop the disease process. If you have arterial disease, you should make changes in your lifestyle to preserve the success of your angioplasty. You should consider changes that will help lower your blood pressure and decrease the chances that arterial disease will affect your arteries. These changes include: Eating foods low in fat, cholesterol and calories Page 4 of 5

5 Maintaining your ideal body weight Exercising aerobically, such as brisk walking, for 20 to 30 minutes at least 5 times per week Stop smoking. What happens if I decide not to have the investigation? You will be referred back to the vascular consultant and other options discussed. Where can I get more information? Radiology nurses can be contacted on: Monday to Friday The vascular nurse at the Queen Elizabeth Hospital can be contacted on: (answer machine). Monday to Friday NHS direct 24 hours a day on Vascular surgical society of Great Britain and Ireland at Reference: British Society of Interventional Radiology (2002) Iliac Angioplasty Study (BIAS 2001). Dendrite Clinical Systems Ltd Information Leaflet: NoIL35 Version: 3 Title: Information for Angiogram and Angioplasty First Published: October 2006 Last Reviewed: December 2012 Review Date: December 2014 Author: Maggie Williams Clinical Lead Radiology, Joanne Coleman, Modern Matron Surgery This leaflet can be made available in other languages and formats upon request Page 5 of 5