Peripheral Angiography

What is a peripheral angiogram?

A peripheral angiogram is a test that uses X-rays and contrast dye to help your health care team find narrowed or blocked areas in one or more of the arteries that supply blood to your legs, feet, or in some cases, your arms and hands. The test is also called extremity angiography.

Why do people have this test?

The peripheral angiogram helps you and your health care professional decide if a surgical procedure is needed to open blocked arteries. Peripheral angioplasty is one such procedure. It uses a balloon catheter to open the blocked artery from the inside. A small wire mesh tube called a stent is usually placed in the artery during angioplasty to help keep it open. Bypass surgery is another procedure. It re-routes blood around the blocked arteries.

What are the risks?

Serious risks from peripheral angiograms are very unlikely. Some complications may include:

• Bruising, bleeding or tenderness at the area where the artery was entered
• Injury or damage to an artery caused by the thin tube (catheter) that’s inserted into your artery during the test
• Blood clot at the location of the needle puncture
• Allergic reactions to the dye used in the test. (This reaction may manifest itself with itching, rash or breathing problems. Tell your doctor if you have ever had an allergic reaction to X-ray contrast dye or iodine substances.)

How do I prepare for the test?

• You’ll get instructions about what you can eat or drink during the 24 hours before the test.
• Usually, you’ll be asked not to eat or drink anything for 6 to 8 hours before your peripheral angiogram.
• Tell your health care team about medicines you take, including over-the-counter drugs, herbs and vitamins. They may ask you not to take your medicines before your test. But don’t stop taking your medicines until you are asked to do so.
• Tell your health care team if you’re allergic to anything, especially iodine, latex or rubber products, medicines such as penicillin or X-ray dye.
• Tell your health care team if you’re pregnant.
• Tell your medical team if you've ever have ever had any problems with excessive bleeding.
• Leave all of your jewelry at home.
• Arrange for someone to drive you home.

What happens during the test?

A doctor with special training performs the test with a team of nurses and technicians. The test is performed in a hospital or outpatient clinic.

• Before the test, a nurse will put an IV (intravenous line) into a vein in your arm so you can get medicine and fluids. You’ll be awake during the test.
• A nurse will clean and shave the area where the doctor will be working. This is usually an artery in your groin.
• A local anesthetic will be administered to numb the needle puncture site.
• The doctor will make a needle puncture through your skin and into your artery, and insert a long, thin tube called a catheter into the artery. You may feel some pressure, but you shouldn’t feel any pain.
• The doctor will inject a small amount of dye into the catheter. This makes the narrowed or blocked sections of your arteries appear clearly on X-rays. The dye may cause you to feel flushed or hot for a few seconds. 

What happens after the test?

• You will go to a recovery room for a few hours.
• To prevent bleeding, the nurse will put pressure on the puncture site for 10 to 20 minutes. Then a bandage is applied to the wound.
• The nurse will ask you not to move the leg used for the catheter and will continue to monitor you for bleeding or swelling.
• Before you leave, you will get written instructions about what to do at home.

What happens after I get home?

• Drink lots of fluids to make up for what you missed while you were preparing for the angiogram and to help flush the dye from your body. For most people, this means drinking at least six glasses of water, unsweetened juice or tea.
• You can start eating solid food and taking your regular medicines 4 to 6 hours after your angiogram.
• Don’t drive for at least 2 days.
• The puncture site may be tender for several days, but you can probably return to most of your normal activities the next day.
• Increase your activity slowly to allow for the incision to heal.
• Your doctor will get a written report of the test results to discuss with you.

What should I watch for?

A small bruise at the puncture site is common. If you start bleeding from the puncture site, lie flat and press firmly on that spot. Then, ask someone to call the doctor who performed the procedure.

Call your health care team if:

• Your leg with the puncture becomes numb or tingles, or your foot feels cold or turns blue.
• The area around the puncture site looks more bruised.
• The puncture site swells or fluids drain from it.

Call 911 if you notice:

• The puncture site swells up very fast.
• Bleeding from the puncture site doesn't slow down when you press firmly on it.