Angiography is a procedure in which X-rays and a type of dye are used to visualize blood vessels. Your doctor may recommend angiography in cases such as chest pain, the presence of congenital heart disease, or coronary artery disease. Since there is a possibility of complications, cardiac tests such as an electrocardiogram (ECG) and echocardiography (ECHO) are generally performed before angiography. The purpose of angiography is to check whether a condition that obstructs blood flow in the vessels has developed. During this process, a dye visible on X-ray is injected into one of your blood vessels. Thanks to this dye, blood flow is tracked and any obstruction is detected. When necessary, your doctor intervenes in the blocked coronary arteries.
The angiography procedure performed may vary depending on which area's blood vessels will be examined:
Coronary angiography: The blood vessels supplying the heart are examined.
Cerebral angiography: The blood vessels of the brain and its surroundings are examined.
Pulmonary angiography: The vessels supplying the lungs are examined.
Renal angiography: The vessels supplying the kidneys are examined.
Peripheral angiography: Examines the vessels in the extremities.
Peripheral angiography can be performed in 2 different ways. The vessel can be reached through the wrist or the groin using a catheter.Peripheral angiography is performed when narrowing or blockage is suspected in any of the vessels carrying blood to the legs, feet, hands or arms. The area through which the vessel is accessed varies. However, it is generally performed through the groin, and the remaining procedures are similar. It is performed with X-rays and contrast dye by a team including a physician, nurse and necessary technicians. It is also known as extremity angiography.
How Is Peripheral Arterial Disease Diagnosed?
Vessels other than those supplying the heart are called peripheral vessels. Any blockage or narrowing that occurs in these vessels is called peripheral arterial disease (PAD). Peripheral arterial disease most commonly occurs in the legs. If you have peripheral arterial disease, your doctor may request peripheral angiography. In general, the symptoms of peripheral arterial disease include:
Pain in the legs that occurs with walking and goes away with rest
Having shinier than normal skin on the legs and feet
Hair loss on the legs
Having constantly cold skin
Tissue gangrene due to insufficient blood flow
Numbness or weakness in any limb
Purple or bluish discoloration of the limbs
Thick, opaque toenails
Pain in the arms or legs while moving
Feeling pain even at rest
Presence of non-healing wounds
Weaker pulses felt in the limbs
Having one or more of these symptoms does not mean that you have peripheral arterial disease. Your doctor will decide whether peripheral angiography is appropriate for you based on various tests and examinations they will perform. As a result of this procedure, your doctor will decide which method to use to open the blocked arteries.
What Are the Risks of Peripheral Angiography?
Peripheral angiography may be a frightening procedure for many people. However, it may be necessary to maintain optimal health. You will not feel any pain during peripheral angiography performed under local anesthesia. Contrary to what is believed, peripheral angiography is a common procedure without major complications. However, as with every procedure, it may carry some risks. Complications of peripheral angiography generally include:
Injury or damage caused by the inserted catheter
Bleeding in the artery, tenderness or bruising of the skin
Allergic reaction to the dye
Irregularities in heartbeat (arrhythmia)
Heart attack
Stroke
Kidney damage
How Is Peripheral Angiography Treatment Performed?
The purpose of the peripheral angioplasty procedure is to improve your quality of life and reduce the risk of conditions such as atherosclerosis, heart attack, or stroke. After this procedure, most of the pain or discomfort you have will decrease.
There are some things to pay attention to before peripheral angiography. When your doctor gives you an appointment for angiography, they will inform you about the foods you should not eat starting 24 hours beforehand. Generally, you will need to stop eating and drinking completely no later than 6 hours before. Sometimes you may be asked not to eat or drink anything at all. Be sure to tell your doctor about any medications you take regularly and about any allergies you have, especially to materials such as plastic, rubber or latex. You may need to avoid drinking before the procedure. Also, make sure you have a companion who will take you home after the procedure.
During peripheral angiography you will usually be awake. Before the procedure, a nurse places an intravenous (IV) line in your arm so that the necessary medications and fluids can be given. Before and during the procedure, the area where the doctor will work is cleaned and shaved. Then the area is numbed with local anesthesia. The doctor makes a tiny hole with a needle in the artery reached from the groin, and a tube called a catheter is inserted into this hole. You may feel slight pressure while the catheter is being placed, but local anesthesia prevents you from feeling significant pain. Dye is injected into the artery through the inserted catheter. You may feel warmth for a few seconds during this time. While the dye circulates through the body with the blood, areas of narrowing or blockage can be clearly seen with the help of X-rays.
After peripheral angiography, you may wait in a recovery room for a few hours until the effect of the anesthesia wears off. To prevent bleeding, pressure is applied to the area for 10-20 minutes, followed by a bandage. Before you are discharged, your doctor or a member of your healthcare team will inform you about what to pay attention to. For example, the first thing you may be told is to drink plenty of water so that the dye can be flushed out of your body. In addition to water, you may also drink tea or fruit juice because of their diuretic effects. You can start eating at least 1-2 hours after the procedure is finished. You can return to your daily activities right away, but it is advisable to avoid movements that would strain the puncture site. Therefore, it will be better for you to gradually increase your activity level.
After the procedure, your doctor will share the results with you. If your doctor finds narrowing or blockage in your blood vessels, they may this time ask you to undergo peripheral angiography surgery.
How Is Peripheral Angiography Surgery Performed?
Peripheral arterial disease prevents the extremities, meaning the arms and legs, from receiving the blood flow needed to meet the body's needs. The legs are especially affected by this condition, and intermittent claudication can occur as a result of the disease. Surgical intervention is essential to relieve claudication or other symptoms. Peripheral angiography surgery, also known as peripheral angioplasty, is a type of minimally invasive treatment. Minimally invasive treatment is known as a treatment option with faster recovery times compared to other methods that involve making incisions of 2-3 centimeters. This procedure, performed under local anesthesia, is carried out by placing a catheter into the artery from the upper thigh, that is, the groin. Then a small balloon-like device is placed inside the vessel. This device is inflated, pressing against the artery wall. Thus, the diameter of the artery is widened.
After the blocked artery is widened, the balloon is deflated and removed. Today, it has been found that placing a stent to keep the artery open has more favorable long-term results. The stent, a braided wire 3-4 millimeters in length, is passed through the catheter and placed in the artery after the balloon inflation process is completed. The stent can also be described as a permanent metal scaffold that keeps the artery open.
Frequently Asked Questions
How long does groin angiography take?
The peripheral angiography procedure may vary depending on the doctor's speed, the equipment used, or the suitability of the setting where the procedure is performed. On average, it may take 30 minutes or 1 hour.
How many hours do you stay in the hospital?
Peripheral angiography is an outpatient treatment option. Therefore, you do not need to spend the night in the hospital after the procedure. However, since local anesthesia is applied, you may need to stay in the hospital for a period of time. This period is usually 6-7 hours. However, this period may vary depending on the hospital or the doctor's decision.
Are you put to sleep during angiography?
Peripheral angiography is not a surgical operation. Therefore, you remain conscious during the peripheral angiography procedure. However, local anesthesia is applied so that you do not feel any pain or discomfort. The effect of the anesthesia wears off within a few hours after the procedure.
Who is it most commonly performed on?
Groin angiography is performed to detect blockage or narrowing occurring in the arteries of the extremities. In other words, the peripheral vessels are of concern rather than the coronary vessels that supply the heart. Therefore, peripheral angiography may be performed especially in peripheral vascular diseases.
What happens if peripheral arterial disease is left untreated? What does it cause? How common is it?
Narrowing or blockage of the vessels detected after groin angiography must definitely be treated. Otherwise, adequate blood flow cannot be provided to the extremities, and this may lead to numbness and weakness in the arms and legs, tissue loss, ulcers on the feet, and, over time, amputation (surgical removal of the limb).
What should be considered after angiography? When can you return to daily life?
Groin angiography is a minor operation performed under local anesthesia that takes an average of 1 hour. Therefore, no long recovery period is needed afterward, and you can return to daily life right away. However, since an incision is made in the vessel, some complications may occur afterward. For this reason, be careful not to move the treated area too much, especially on the first day. Afterward, you can gradually increase your level of physical activity.
Can groin angiography be repeated?
Groin angiography is not a treatment, but a procedure that helps determine what kind of treatment can be applied. Repeating it when necessary generally does no harm, but your doctor will make the final decision after carefully evaluating all the conditions.
