What is a peripheral angiogram?
A peripheral angiogram is a test that uses a specialized X-ray machine and dye to help our vascular specialists find narrowed or blocked areas in one or more of the arteries that supply blood to your legs and determine the best approach to resolve your leg pain.
At South Charlotte General and Vascular Surgery, our PAD specialists perform these procedures regularly in our fully accredited angiography suite. They have all the necessary tools to treat both arterial and venous problems right here in our South Charlotte state of the art facility.
Why do I need peripheral angiograms?
A peripheral angiogram (also called arteriogram) may be recommend if blockages in your arteries are significantly interfering with the blood to your legs or, in rare cases, to your arms (PAD) The angiogram helps our specialists decide if a surgical procedure is needed and feasible to open the blocked arteries.
Once the angioplasty is completed, your surgeon will assess the results and determine how well the artery responded. If the blockage persists, a stent is then placed to hold the artery open and prevent it from collapsing again.
What is a peripheral angioplasty?
Once a severe blockage is identified, our vascular specialists will attempt to reopen the blocked artery. Peripheral angioplasty uses a balloon catheter to open the blocked artery from the inside. After the narrowing is reached, the small balloon I spaced across the blockage and inflating causing disruption of the plaque and stretching the artery allowing more blood to flow to your legs. After widening the vessel with angioplasty, your vascular surgeon sometimes inserts a stent depending upon the circumstances. Stents are tiny metal mesh tubes that support your artery walls to keep your vessels wide open
Once the angioplasty is completed, your surgeon will assess the results and determine how well the artery responded. If the blockage persists, a stent is then placed to hold the artery open and prevent it from collapsing again.
How is it done?
After our dedicated team members prepare you for the procedure and confirm your name, correct side and procedure, they will clip the hair at the site where your surgeon is planning to access the blood vessels to reduce your risk of infection. The nurse will apply monitoring devices to make sure your vital signs remain stable. Your skin is cleansed with antiseptic and you are then covered with a sterile drape. Your surgeon will then begin the procedure by injecting numbing medicine into your skin. Although you may be given a mild sedative, your vascular surgeon will usually want you to stay comfortable but alert to follow instructions and describe your sensations during the procedure.
The nurse will then administer a blood thinner to help avoid clotting during the manipulation of the artery and your vascular surgeon will then insert a guide wire or a guide catheter into your artery. Using an x ray machine (fluoroscopy) that projects moving pictures on a screen, your surgeon can clearly follow and guide the catheter through your blood vessels. Your surgeon will then inject dye and take the initial pictures from your belly button all the way down to your feet. Your surgeon will carefully study the pictures and determine the exact location, degree, type of blockage to guide him in deciding the next steps.
If the blockage is quite severe, your surgeon may use an atherectomy device (roto-rooter) to allow the balloon angioplasty to fully inflate the blood vessels and secure a better result. Your surgeon may the use an intravascular ultrasound, which is a camera that travels inside your blood vessels and help determine the adequacy of the angioplasty. If needed, a permanent stent is then inserted, and it remains in place to support the walls of your artery. Your artery walls grow over the stent, preventing it from moving.
Once the procedure is terminated, your surgeon will remove the catheters and seal the puncture site with a special device that functions like a plug. Pressure may need to be applied for 10-15 minutes.
Angioplasty and stenting usually takes on average between 45 and 90 minutes. You are then taken back to the recovery room where our team will ensure your comfort and monitor your progress before discharging with clear instructions.
To watch a short video about the procedure click here
How do I prepare?
Our team is committed to your comfort and safety and will spare no effort to make your procedure as seamless as humanly possible. They will give you the necessary instructions you need to follow before the procedure, including fasting and not taking some of your medications if applicable. Usually, the team will ask you not to eat or drink anything several hours before your procedure.
Before your procedure, our team will also order blood tests to check your kidney function which can be affected by the contrast if your kidneys are functioning normally.
If you have any allergies to contrast dye, which is also used for other imaging studies like CT scans, you should tell the team ahead of time. Since the contrast dye contains iodine, you should also let your vascular surgeon know if you have allergies to iodine or shellfish (most of which have iodine) or egg white.
Is it safe for me to have the procedure?
We will take every precaution to ensure that your procedure goes as smoothly and safely as possible. However, despite all our efforts, some of the following complications to angioplasty and stenting may still occur:
Reactions to the dye
- Bleeding at the access puncture site
- Weakening of the wall of the artery at the puncture site which may need to be Treated if the artery becomes very weakened
- Rupture of the artery which is often controlled with pressure but may require immediate hospitalization in extreme cases.
- Re-blocking of the treated artery or clotting
- Kidney problems
- Embolization: if plaque particles break loose during the angioplasty procedure, blockages can develop in the arteries downstream from the plaque. When severe, blood flow to the foot and toes may be interrupted requiring additional interventions
Am I at risk of complications?
You may have a higher risk of complications from the dye if you have diabetes or kidney disease. Our surgeons work very closely with your doctor to minimize the impact of the procedure on your health and prevent any foreseeable complication.
- If you had a similar procedure in the past and suffered a complication, please let your surgeon know before the procedure.
- If you notice any unusual symptoms after your procedure, you should let a member of our team know immediately. These symptoms will be clearly described in your discharge instructions.
A follow up will be scheduled as well as a test to monitor the results of the procedure.
At South Charlotte General and Vascular Surgery, we make every effort and take every precaution to ensure that you have a safe procedure and that you have a speedy recovery.
To inquire about the procedure or our facility, please call or book an appointment with one of our PAD specialists.
