Information About Your Peripheral Vascular Procedure
About Your Procedure
Preparing for the Procedure
When should I arrive for my peripheral vascular exam?
During the Procedure
Going Home After Your Procedure
When to Notify Your Doctor
About Your Procedure:
- Angiography is a test that allows your physician to visualize your blood vessels on an X-ray, MRI, or CT scan. The doctor will use a local anesthetic to numb the insertion site (usually the femoral artery located on the groin area but is sometimes in the arm or wrist) and place a small tube/catheter into the vessel. After the catheter is in place, you should only feel mild pressure in the area.
- Catheters will then be placed through the insertion site and will travel to the area in the body that is being studied. Dye will be injected to help the arteries show up better on X-ray pictures. The doctor is then able to observe the flow of the dye through the blood vessels and locate any narrowed or blocked areas.
- If a narrowed or blocked blood vessel is discovered, the physician may proceed with treatment of the blockage using a procedure called balloon angioplasty/stenting of the artery. In balloon angioplasty, the radiologist or other physician guides the catheter, under X-ray, to the site of the narrowing and a balloon is inflated to press open the narrowed blood vessel. In many cases, a stent is then inserted through the catheter and left behind in the blood vessel to keep it open. A stent is a small, cylinder shaped metal tube. This procedure allows the blood flow to the area to return to normal, thus opening the artery.
- In some cases, blood clots can be treated during the procedure also. In this procedure, certain medications, called thrombolytic agents are used to dissolve or breakup clots.
Preparing for the Procedure:
- It is very important that you do not eat or drink anything after midnight the night before the procedure to prepare for peripheral vascular angiography.
- Please shower and wash thoroughly with an antibacterial soap the evening before or the morning of your procedure.
- Please take your morning medications as directed by your physician with small sips of water.
- Your physician will order blood tests or lab work to be completed prior to the procedure. All lab work should be completed prior to the day of the exam and can be collected at St. Mary's Center for Advanced Medicine.
- Diabetic patients: Please contact your doctor for instructions regarding whether to hold or adjust dosages of diabetic oral medications and insulin the day of your procedure as you will be unable to eat.
- Patients taking blood thinners (Coumadin, Aspirin, Plavix): Please contact your doctor regarding whether to temporarily hold this medicine before the procedure. In many cases, blood thinners/anticoagulant medicines are stopped 3-5 days prior to the procedure to decrease the likelihood of bleeding and to allow coagulation levels to return to normal. Your physician will need to decide if stopping your blood thinner is safe for you.
Note: Please notify your doctor immediately if you are allergic to iodine or shellfish. Contrast dye will be injected during the exam and you will need to be treated with additional medication to avoid an allergic reaction to the dye if you are allergic to iodine or shellfish.
Where should I arrive for my peripheral vascular exam?
- The procedure will be completed at St. Mary's in the Center for Advanced Medicine building in the Peripheral Vascular Lab.
- The Center for Advanced Medicine (CAM building) is located on the campus of St. Mary's Medical Center and has its own separate entrance and registration desk. The Center for Advanced Medicine building is located on the northwest side of the hospital and the parking for the building is most easily accessed from the Bellemeade entrance.
- Please arrive at the front desk of the Center for Advanced Medicine at least 2 hours before the exam is scheduled to begin.
- Upon arrival to St. Mary's, please register at the front desk and the staff will be notified of your arrival.
- At the appropriate time, our peripheral vascular lab staff will greet you in the front lobby and escort you and your family back to our pre-procedure holding area. You will be placed in a private room to be prepped for the exam.
Please note: Two family members will be allowed to remain in the private holding room with the patient.
During the procedure:
- The procedure will be completed in the Peripheral Vascular Lab. Your family will be directed to a special holding area nearby.
- In the holding area, the staff will prep you for the procedure. You will be asked to answer a series of questions regarding your medical and health history. You will be provided with a hospital gown to wear during the procedure.
- An IV, or intravenous infusion will be started in your arm to inject medications during the procedure.
- Upon entering the room, you will be placed on a narrow exam table. The insertion site (near the groin area) will be shaved and prepped with an alcohol and iodine solution. A sterile drape will be placed over you and the table.
- You will be hooked up to various monitoring equipment for the procedure and your vital signs (blood pressure and heart rate) will be monitored frequently.
- You will be given medication to sedate/relax you during the procedure; although, you will remain awake during the procedure.
- Your physician will use a local anesthetic to numb the insertion site area. You may feel a stinging sensation as the local is injected.
- You may experience a feeling of pressure at the insertion site after the area is numbed. Most patients experience only mild discomfort during the procedure.
- The catheters are then inserted into the artery and the dye is injected.
- Patients sometimes experience a flushed or hot feeling when the contrast dye is injected.
- During the procedure, you can often see the images of your blood vessels on the X-ray machine as the doctor injects the dye.
Special Note: An average exam in the peripheral vascular lab lasts about 90 minutes. This time can vary depending upon the patient and the exact procedure being performed.
After the Procedure
- After the procedure is completed, you will return to the private holding area room or be admitted to a room within the hospital depending on the type of procedure that was performed.
- Some physicians elect to admit patients to the hospital overnight after a balloon angioplasty or stent placement.
- Some patients will be discharged on the same day of their procedure.
- After the procedure is completed, the catheter will be taken out of your artery. Firm pressure will be applied to the insertion site area and will be held until the artery seals over so that it will not bleed. Sometimes a special device or sandbag is used to continue applying pressure to the area.
- You will need to lie flat in bed and keep your arm or leg straight for several hours following an angiogram. Do not lift your head, raise the head or foot of your bed, sit up or bend until your caregiver says you are permitted to do so. Moving too soon after angiogram may cause serious problems.
- The insertion site, the affected extremity and your vital signs will be monitored frequently after the procedure.
- You must use a bedpan or urinal until you are permitted to get out of bed and go to the bathroom.
- Bleeding, pain, or swelling around the insertion site should be immediately reported to our staff.
- Eating and drinking after the procedure is permitted.
- It is important to drink fluids after your procedure and for the next 24 hours to help flush the dye out of your body.
Going home after your procedure:
- You should arrange for an adult to drive you home following the procedure. It is best to have another adult remain with you for 24 hours following the angiography procedure.
- Before leaving the hospital, you will be given the proper guidelines for activity, diet, and medications.
- You will be instructed to avoid vigorous activity and lifting over 5 pounds for 24 hours following the procedure. Limit lifting over 10 pounds for one week.
- In most cases, it is safe to drive after 2 days.
- The insertion site area should be kept clean and dry for 24 hours following the procedure. Cover the site with a band aid or bandage for the first 24 hours.
- After 24 hours, it is safe to take a shower. Remove the bandage from the hospital before showering.
- Gently cleanse the site using mild soap and water while standing in the shower. Dry thoroughly without excessive rubbing.
- Do not apply powders or lotions.
- Keep the site clean and dry to prevent infection. If the bandage becomes wet, remove that one and replace with a new one.
- Do not sit in a bath tub or pool of water for 7 days or until the wound has healed.
- You may resume normal activity in 2 days, including driving.
- A small area of bruising and mild tenderness around the access site is acceptable.
Please notify your doctor immediately if you experience any of the following symptoms following your procedure:
- Bleeding at the insertion site that does not stop after 10 minutes of applying firm pressure directly on the incision.
- Severe pain in the insertion site area, in your abdomen, or in your back
- Swelling at the site or affected limb
- Fever over 100.5 degrees
- Foul smelling drainage or pus coming from the insertion site
- Severe/worsening redness of the site
- Chest pain or pressure
- Cold extremity, numbness, or discoloration of the affected leg