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How Angiograms Can Diagnose PAD

How Angiograms Can Diagnose PAD

Over a period of time, the arteries in the legs and heart can become narrow or blocked due to fatty deposits on the arterial walls. The purpose of an angiogram is to find out the location and extent of blockage, and what to do about it.[1] Angiogram is part of a general group of procedures known as cauterization. This procedure is mainly to diagnose and treat blood vessel conditions. 

Most people generally do not suffer any complications from angiograms except a small bruise. During the procedure, the physician will inject a type of dye that is visible on X-ray machines into the blood vessels. The machine takes a series of images or angiograms for interpretation by a radiologist. 

An angiogram works similar to an X-ray. Normally, your blood vessels cannot be seen in an X-ray. However, during an angiogram there is an iodine dye used to help improve visibility of the vessels for treatment. Angiography is performed by an interventional radiologist, a physician that specializes in minimally-invasive procedures.

Precautions Before Angiogram 

You should stop eating anything after midnight before the day of your angiogram, and avoid taking any non-steroid, non-inflammatory medications one week prior. You should stop smoking at least 24 hours before your test, take only half of your short-acting insulin dose on the morning of your test, while other regular morning medications may be taken with a small amount of water.[2] 

Your doctor may recommend angiogram if they notice  any signs of blocked or narrowed arteries, abnormal stress levels, or if you experience chest pain, heart attack, stroke or heart failure.[3]

Before your angiogram, your physician will review your medical history, any medications you are taking, and check your blood pressure, heart rate and blood sugar levels. You will also need to empty your bladder, remove jewelry and change into a hospital gown. Your blood test may be done prior to your angiography to check your kidney function. This is important because the kidneys need to work properly in order to flush out the dye.[4]  

What Is Angioplasty and How It’s Done 

The procedure to open the clogged vessels is known as angioplasty. For this, a catheter (thin long tube with camera mounted on it) is placed alongside a long, thin guide-wire, and a contrasting dye is injected into the bloodstream through the catheter to make the blood vessels visible on the X-ray monitor or fluoroscope. A special device equipped with an inflatable balloon is then placed across the blockage. The balloon inflates when it reaches the blockage in order to compress it. It then deflates and is carefully removed while keeping the wire in place across the area to be treated. 

Tell your doctor if you are pregnant, had previous iodine injections, heart condition or kidney problems before your angiography.  

Local anesthetic will be injected into your groin to numb the areas for making a small incision in order to insert the catheter. You may be offered sedative if you are nervous, but many patients don’t need it. You will be very sleepy during the procedure but should be able to be easily awakened to follow any instructions. 

Procedure Done Under Local Anesthesia 

A small incision will be made in your groin and a catheter (camera mounted thin tube) will be inserted through as sheath into your blood vessel, and carefully threaded to the location of blockage. You shouldn’t feel any discomfort or pain as you will be under local anesthesia. A contrast dye will be injected into the catheter to see the blockage. You may feel a brief sensation of flushing or warmth while the dye is being injected. The dye is easy to see on X-ray images, and it helps the interventional radiologist to see the blockage in your artery more clearly. The procedure is usually completed within an hour, but may take longer if it is followed by balloon angioplasty or placement of a stent to clear the blockage.[5] 

Drink Plenty Of Water After Your Leg Angioplasty 

Some people are sensitive to contrast dye and may have a feeling of warmth throughout the day or a metallic taste in their mouth. You will be encouraged to drink more water after the procedure to flush out the dye, which is particularly important for people with kidney problems.[6] 

The angiogram helps your doctor to see:

  • About the atherosclerosis or blockages in your arteries
  • Exact location of the blockages
  • Extent of blockage
  • Check the blood flow through the blockage 

At the USA Vascular Centers, we provide a non-surgical procedure for PAD using advanced imaging technology or angiography to precisely treat the blockages in your legs. 

Stent Angioplasty at USA Vascular Centers 

Our non-surgical PAD treatment method produces a 3-D image of your blocked artery so that your PAD doctor can see the exact location of the  blockage. This allows them to provide you with PAD treatment through balloon angioplasty.

Your Blockage Is Opened Non-surgically 

Since the stent is left in at the blockage site, your blood flow will be normalized and your PAD condition along with other PAD complications and symptoms will be treated over a period of time. Your puncture site in the groin will be closed with the help of pressure and bandage after your non-surgical PAD treatment before you are discharged. 

After the procedure, you will be transferred to the day unit for bed rest and your condition will be monitored for some time. Before being discharged, you will be encouraged to walk around for a while so that you feel better. 

Since you will receive mild sedation, you will not be able to drive yourself home safely. Arrange for some transportation to reach your home safely after your non-surgical PAD procedure. You must not operate machinery for the rest of the day. 

Post Procedure Medications and Care 

Once you are home, avoid heavy lifting and strenuous leg activities for 2 days to prevent the risk of blood leakage at the puncture site. After the successful completion of balloon stent angioplasty, you can have someone take you home. You can then resume most other activities just after a couple of days. 

Take all the post-procedure medications regularly as prescribed by your doctor to prevent any PAD complications such as cramping pain in the legs, reduced mobility, lowered quality of life, fatigue, tissue death (gangrene) and removal of foot or lower leg due to tissue death and infection caused because of blocked blood supply.   

To get yourself evaluated for PAD, please contact us at 888-773-2193, or you can also schedule your appointment with one of our specialists online. 

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