ABC of Vascular Disease

Angiogram

1. What is an angiogram?
An angiogram is a special x-ray of the arteries. Normally arteries do not show up on x-rays and to make them visible a special dye must be injected into the artery before the x-ray is taken. In order to do this a small plastic tube must be put into the artery through the skin, usually in the groin. A small amount of local anaesthetic is used to make the skin numb first. An angiogram requires sophisticated x-ray equipment and patients are normally admitted to hospital for a day to have this investigation. After the angiogram is done the patient should rest for a few hours to ensure that the small hole in the artery seals securely.

Angiography is a safe procedure but complications do sometimes occur. These issues will be discussed with you before you sign a consent form for the procedure.

2. Are there any special precautions to take before having an angiogram?
Patients with kidney disease, diabetes, high blood pressure or on anticoagulant drugs have to take special precautions and an angiogram should only be done if there are good clinical reasons.

	If you have kidney problems an angiogram should only be done if clinically indicated as the special dye is removed from the blood by the kidneys and can cause further impairment of kidney function.
	If you are diabetic and take the drug METFORMIN you are usually required to stop the drug for 48 hours before and after an angiogram is done as there is a small risk of causing kidney damage.
	If you suffer from high blood pressure (hypertension) then this should be well controlled with tablets before an angiogram is done as there is a higher risk of bleeding from the puncture site.
	If you take anticoagulant drugs such as WARFARIN then these should be stopped before an angiogram is done and may need to be replaced with a more controllable drug such as HEPARIN. Your radiologist will organise this for you before coming for the angiogram.
	If you have a known allergy to iodine then great care should be exercised in the use of iodine containing dyes that are used in angiography.

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