Peripheral Angiography and Intervention
Peripheral angiography is an outpatient diagnostic study for patients who may have blocked blood vessels in their legs and lower body. Utilizing an iodine-based dye that is injected to make arteries (which aren't detectable by X-rays) visible when mixed with blood, doctors can have a "map" of a patient's blood vessels to determine if there's disease or blockage and where the problem is located.
In the short term, blocked arteries can lead to leg cramps and can deter wounds in the lower extremities from healing properly. In the long term, the condition can set the stage for high blood pressure or stroke. A peripheral angiogram may also be used to detect potential blood-flow problems in the upper body and in the abdominal area.
The angiogram procedure can take as little as an hour, or as long as three hours to be completed, and the procedure is performed under local anesthesia, while the patient is awake.
After the doctor makes a small incision in an artery, generally near the groin area, a hollow tube is inserted into the vessel, which paves the way for a thin tube -- known as a catheter - to be placed into the artery (generally the femoral artery) and the "contrast material" dye is injected into the guiding catheter and X-rays are taken of the blood vessels in question.
Patients should inform their doctors if they're allergic to the dye and are advised to drink plenty of water on the day before the procedure to ensure they remain hydrated and to lessen the effect of the dye on the kidneys, which eventually expels the dye through urination. Patients may feel a slight sting at the time of the incision, some uncomfortable pressure when the catheter is inserted and a hot sensation when the dye is injected.
Once the catheter is removed, pressure is placed on the incision site for approximately 10 minutes, and patients are advised to lay flat from two to six hours. Upon examination of the X-rays, the doctor will then advise the patient on treatment options.
If a narrowing of the artery is detected, the doctor may opt to insert a percutaneous transluminal angioplasty (or PTA), which utilizes a small balloon to improve blood flow to the legs. The doctor may insert a stent (a metal or mesh tube), attached to a balloon, which expands the stent - which remains permanently in the artery - when it is deflated and opens the artery.
Some patients are able to leave the hospital the day of the procedure (although they aren't allowed to drive themselves home) and others usually don't stay more than another day. The patient is advised, once arriving home, to drink extra fluids to flush out any remaining dye, to take all medications as instructed, and to refrain from any heavy lifting or strenuous activity for several days.