Peripheral Angiogram Patient information leaflet (262kB pdf)
Introduction
We hope this guide will answer your questions about your peripheral angiogram procedure. Please contact the team if you require further information via the details at the end of this leaflet.
What is a peripheral angiogram?
This is an X-ray examination to show the arterial blood flow to parts of the body, for example, the arms or legs.
Why do I need a peripheral angiogram?
You may have been experiencing pain in your arms, legs, calves and buttocks whilst resting, walking or during exercise. This may be caused by reduced blood circulation. An angiogram will provide information about your blood supply, which will help decide what treatment you may need.
Who will be doing the peripheral angiogram?
The doctors in charge of your case will have discussed the situation with the radiology department and have agreed that a peripheral angiogram will be the best procedure to investigate the issue. A radiologist will perform the procedure. A radiologist has special expertise in using x-ray equipment and in interpreting the images produced. They will look at these images whilst performing the angiogram.
What are the associated risks?
X-Ray radiation: All x-ray procedures involve exposure to radiation in varying amounts. The dose you get from a medical x-ray is very low and your doctor along with the radiologists have determined that the benefits of having the examination outweigh potential risks. The radiographer is present throughout your test making sure that the radiation dose is kept as low as reasonably possible and the duration and level of x-rays are kept to a minimum.
Contrast medium: This procedure will require an injection of a special dye (contrast media) into the arteries. The dye is eliminated from the body through the kidneys. A very small number of patients have an allergic reaction to the x-ray dye. This can be minor, severe, or even life threatening but the chances of this occurring are very rare. Before your examination begins the radiographer will ask you a series of questions about your medical history, including any allergies you may have. This will help us assess if you are at risk of an allergic reaction to the x-ray dye.
Procedure risks: Angiograms are safe procedures but, as with any medical procedure, there are some risks and complications that can arise, these typically include:
- A small bruise (common). This can occur around the site of the needle, but it’s quite normal. The bruise might be sore for a few days but will disappear in a few weeks.
- A large bruise/haematoma (uncommon). This may develop and could require a small operation to drain it. This can lead to a wound infection (rare).
- False aneurysm (rare). A tender pulsating swelling called a false aneurysm may develop over a few days due to ongoing leakage from the arterial puncture site. This can usually be treated by an injection of a blood-clotting agent under ultrasound guidance.
- Kidney injury (rare). The iodine in the contrast dye is very safe but can occasionally affect kidney function, particularly if there is already some kidney damage, identified by the pre- procedure blood tests. Intravenous fluids and medication can be given before and after the procedure to try to reduce this risk.
- Blockage of the arteries (very rare). Some damage can be caused to the artery by the catheter or if material causing a blockage is dislodged and causes a blockage in other arteries (an embolus). This may require an operation or another procedure to resolve it.
- Limb loss (extremely rare). The procedure is performed to improve the blood flow into the leg but any intervention carries a risk of worsening the situation and threatening the long term survival of the leg.
Patients aged 12 to 55, could you be pregnant? X-rays can be harmful to an unborn
baby and should be avoided by patients who are or may be pregnant. It is recommended that the examination is performed within 10 days of the first day of your menstrual period. If your appointment is not within this time or if you think you may be pregnant, please contact the X-ray department before your appointment. When you arrive for your CT scan, you will be asked when your last period started. If it is more than 10 days earlier, your appointment may be postponed.
Breastfeeding: : During the procedure, you will be given an injection of contrast medium. These agents are low risk contrast agents. A very small percentage of the injected contrast enters the breast milk but virtually none is absorbed across the gut of the infant. No special precautions are required and you can carry on breastfeeding as normal. However, if you have any concerns you may want to express some breast milk prior to your appointment.
Preparing for your procedure
You may be asked not to eat for four hours before the procedure, although you may still drink clear fluids such as water. Please continue to take all medication that can be taken with water only. If you are an insulin-dependent diabetic DO NOT take your insulin in the morning, but please bring it with you to the hospital. You should arrange for someone to be with you the night after the procedure, as you must not be left alone. Please leave any jewellery or valuables at home. Please contact the booking team before your appointment if:
- you are or think you may be pregnant
- you have had a previous allergic reaction to contrast medium (X-ray dye) or are allergic to iodine.
- you are a diabetic taking Metformin.
- you weigh over 30 stone/190 kilograms
- you plan on using hospital transport or need a hoist to transfer
- you require an interpreter – please inform us as soon as you receive your appointment letter, and we will arrange an interpreter for you
If you are unsure or have questions about your preparation, contact your doctor or the X-ray department for advice.
Allergies
If you have any allergies you must inform your doctor. If you have previously reacted to contrast medium you must tell your doctor about this.
Medication
Please contact the radiology department if you are taking blood thinning medication (anticoagulants) such as Warfarin, Aspirin, Rivaroxaban, Dabigatran, Apixaban, Edoxaban, Clopidogrel or Ticagrelor. You may be asked to stop taking them ahead of the procedure or be given alternative medication.
Getting to us
Once you have arrived at The Princess Alexandra Hospital (Hamstel Road, Harlow, Essex,
CM20 1QX), follow the signage to the radiology reception, which is located on the ground floor, green zone. Please let the radiology receptionist know that you have arrived for your appointment.
When should I arrive?
Please arrive in the radiology department at your given appointment time. A notification
through text or letter should have been sent to you to confirm this appointment.
Can someone stay with me in hospital?
You may have a friend or relative attend with you, but they will be asked to stay in
the waiting area while you have your procedure.
Children are not allowed in the waiting area unattended. Our staff are not permitted to
supervise children, so please ensure child care arrangements are in place to avoid your
tests being rescheduled.
The day of the procedure
You will be shown to a cubicle and asked to undress and put on a gown; please bring a dressing gown if you have one. You may also be asked to remove jewellery, dentures, glasses, or other metal objects, which may show up on the X-rays.
The procedure
Your identification will be checked by a nurse and radiographer, a brief history will be taken; please tell the radiologist what medication, severe allergies, choking episodes or other medical conditions, such as thyroid disease and diabetes you may have. Before the procedure, the interventional radiologist will explain the procedure and ask you to sign a consent form. Please feel free to ask any questions that you may have and, remember that even at this stage, you can decide against going ahead with the procedure if you so wish. You will then be taken into the special X-ray room where you will be asked to lie down on the X-ray table. The radiographer will position your legs so that they are kept very still during the procedure. The nurse will clean your groin area with cold antiseptic and then cover the area with sterile towels. The radiologist will inject some local anaesthetic into the area, which will sting at first and then turn the area numb. A small tube is then inserted into the artery in the groin. The X-rays are taken while contrast (x ray dye) is injected through the tube into the artery. During this time, you may experience a warm sensation over the lower part of the abdomen, or you may feel that you have passed water. This is a normal response to the contrast being injected into the artery. Once the X-rays are taken the small tube is withdrawn from the artery. The radiologist may then have to press on the area for a short while to help stop the bleeding.
How long will it take?
This will depend on the situation and procedure. The procedure may take up to an hour, although you will be in the department for a longer period to ensure no there have been no complications.
Is it uncomfortable?
This procedure is not painful but, it can be uncomfortable and unpleasant.
After the procedure
You will be taken to the recovery area where you will need to lie flat for an hour. We will then sit you up and give you a cup of tea or coffee. A nurse will carry out routine observations, such as taking your pulse and blood pressure, to make sure there are no problems. You may go home after 3-4 hours of bed rest. The nurses will monitor your blood pressure and vital signs during this time.
Can I drive after my procedure?
We recommend that you do not drive for twenty-four hours and you ask a friend or relative to drive you home following your procedure.
How soon can I return to work?
We recommend you do not undertake strenuous activity and rest for the remainder of the
day.
What do I do if I feel unwell after I have gone home?
Sometimes you may experience some bruising and discomfort around the area. This is where the local anaesthetic has worn off. Occasionally the small puncture site in the groin area may bleed. You will be given an advice sheet to take home, which will explain what you need to do if this happens. If the bleeding is excessive, you should contact your GP or come to the A&E department and tell them what procedure you have had.
When will I get my results?
You will not know the results of your examination immediately. The radiologist will report their findings to the clinician who arranged your procedure, who will discuss the results with you. It usually takes a couple of weeks for the results to become available.
Contacting the team
- If you have any further questions about your procedure or an existing appointment, please contact the radiology department (Monday to Friday, 9am to 4pm) at 01279 82 2527 or 3405
- If you have any queries outside of working hours (after 4pm and on weekends), you will be redirected to the main radiology reception. Please note appointment bookings cannot be made during this time.
Your feedback matters
- If you would like to give feedback on your care, please contact our patient experience team at [email protected] or 01279 827211.
- Please contact the communications team at [email protected] if you would like this leaflet in another language or format.