Advice after your nerve block for surgery
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Introduction
We have been advised by your hospital consultant that you need to have an angiogram and/or vascular procedure performed in the Radiology (X-ray) Department. This information tells you about having an angiogram, what is potentially involved, and what the possible risks are.
This leaflet may not answer all your questions, so if you have any queries or concerns,
please contact us using the telephone number on your appointment letter, or ask the ward staff.
What is an angiogram?
An angiogram is a procedure where x-rays are used to examine blood vessels, normally arteries. Normally blood vessels do not show up on ordinary x-rays so a special dye, called contrast medium, is injected into the artery through a fine plastic tube called a catheter which is normally inserted into a peripheral vessel such as in the groin or arm. Fluoroscopy is a process that uses X-rays to produce a real time moving image on a television monitor and X-rays are taken during the injection and detailed images of the arteries are obtained.
The procedure will be performed by a radiologist (doctor specialising in medical imaging) who will be assisted by a radiographer and a radiology nurse.
The angiogram can be used as a diagnostic tool but also to help to insert a device into the artery such as a venous access device, stent or filter. It can also be used to confirm the correct position of the tip of a catheter that will be left in place such as to administer medication.
Before your appointment
Please let us know if:
- you are taking any medication which impair the bloods ability to clot (anticoagulation or blood thinning drugs) e.g. Warfarin or clopidigrel, or, if you are aware that you may have bleeding problems. The radiologist who will be performing your examination can be notified and may need to discuss this with you and your hospital consultant before your appointment can be confirmed as the medication may need to be stopped or changed before the procedure. The Interventional nursing team can be informed on 0300 613 2161 (Frimley) or 0300 615 3544 (Wexham).
Please also let us know if:
- you have limited mobility and will require assistance to get on and off the scanner.
- you will need an interpreter. We are not able to use family members or friends to interpret.
- there is any possibility that you may be pregnant. All patients from 12-55 years of age (regardless of gender) who will undergo a Radiology procedure will be asked about the possibility of them being pregnant.
• you are diabetic - please note that you are required to starve before the examination. You may be given an early morning appointment or alternative medication will be given on the ward.
In order to make your appointment run more smoothly, please let us know if any of these apply, in advance, by calling our bookings team (contact details are displayed on the main Radiology page).
Please review the contrast safety questionnaire enclosed in this letter and fill this in before your appointment. This can be completed on paper and where indicated this can also be completed online.
What to bring with you
If the study is to be performed as an ambulatory outpatient you do not need to bring anything special. Please bring with you to your appointment any sprays or inhalers that you may need and a list of any regular medications you are taking.
Some procedures require you to be admitted as a day case and this will be indicated on the appointment information
During the procedure
Referral and consent
You will be asked to sign a consent form confirming that you understand the procedure and are aware of the risks and benefits involved. Where practical this is usually done on the ward, before you come to the Radiology Department or in an outpatient clinic environment before your admission to the hospital.
The procedure is normally done as a planned procedure and you should have plenty of time to discuss the situation with your doctor or the nurse specialist looking after you before you sign the consent form. When you arrive for the procedure you will also discuss the procedure with the radiologist who will be performing the procedure who will again sign the consent form with you.
If after discussion with your hospital doctor or radiologist, you do not want the procedure carried out, then you can decide against it. If the radiologist feels that your condition has changed or that your symptoms do not indicate such a procedure is necessary then they will explain this to you and they will communicate with the referring doctor who will review your situation as soon as possible. At all times the radiologist and referring doctor will be acting in your best interests.
Procedure
The procedure will be further explained to you by the radiologist and you will be able to ask any further questions that you may have
You will be asked to lie on the x-ray examination table, generally flat on your back. During your procedure, a nurse may monitor your blood pressure, pulse, oxygen levels and heart rate. It is important that you stay very still until the procedure is over. If you are uncomfortable please let the doctor know
The skin near the point of insertion, probably the groin, will be cleaned with antiseptic and then the rest of your body will be covered with a theatre drape.
The skin and deeper tissues over the vessel will be anaesthetised with local anaesthetic and then a needle will be inserted into the vessel. Once the radiologist is satisfied that this is correctly positioned, a guide wire is placed through the needle and into the artery. The needle is then withdrawn, allowing a fine plastic tube called a catheter to be placed over the wire and into the artery.
The radiologist uses the x-ray equipment to make sure that the catheter and the wire are moved into the correct position and then the wire is withdrawn. A special dye (contrast medium), is then injected through the catheter and x-rays are taken.
Once the radiologist is satisfied that the x-rays show all the information required, the catheter will be removed. A seal (Angioseal) is then normally placed in the artery at the puncture site to close the small arterial opening or pressure applied until there is no evidence of bleeding.
Will it hurt?
Some discomfort may be felt in the skin and deeper tissues during the injection of the local anaesthetic.
You may feel the doctor changing and moving catheters in and out. Although this is
sometimes slightly uncomfortable, it should not be painful.
As the dye, or contrast medium, passes around your body, you may get a warm feeling, which some people can find a little unpleasant.
How long will it take?
Every patient’s situation is different and it is not always easy to predict how complex or how straightforward the procedure will be. Generally the procedure takes between 30 and 60 minutes.
What happens afterwards?
Depending on the procedure you may be able to leave after the procedure is finished or you will be taken to a recovery area or the day-case unit or ward.
If you have any problems after the procedure please speak to the staff on the ward or contact your GP or emergency doctor if problems occur when you have returned home
Risks
As with any procedure or operation, complications are possible. We have included the most common risks and complications in this leaflet. The possibility of these occurring will vary for each patient and the possibility of these happening to you will be discussed with you, before you sign the consent form.
Bleeding: Any intervention on a blood vessel carries a risk of bleeding. There may be a small bruise around the site where the needle has been inserted and this is quite normal. There is a chance that the bruise may become very large and uncomfortable, but this does not happen very often.
Infection: If a large bruise develops there may be a risk of it getting infected, and this would be treated with antibiotics
X-rays are a type of radiation. We are all exposed to natural background radiation every day from the sun, food we eat, and the ground. Exposure to medical X-rays carries a small additional risk, but your doctor feels that this risk is outweighed by the benefits of having the test and the amount of radiation you will receive is kept to as low as reasonably possible
Contact us
If you have any queries relating to this information, please contact the Radiology service.
About this information
Service:
Radiology
Reference:
PILS-IR.13
Approval date:
2 October 2024
Review date:
2 October 2027
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Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.