An arteriogram is a special X-ray picture of the blood vessels (arteries).

The information in this leaflet is intended to help you understand

• What the procedure involves
• The potential benefits and risks of the procedure

After reading this you may find that you wish to ask some questions about the procedure.  It is often helpful to make a list of any further questions you would like to ask and bring this with you when you come to the hospital.

1.  Why do I need a peripheral arteriogram?

Patients who have been referred for this procedure generally have symptoms due to narrowing or blockage of the arteries.  The exact nature of the symptoms will depend on where in the body the arteries are diseased.

The purpose of the procedure is to take pictures of these arteries to see if any treatment can be offered to help improve your symptoms.

You will have seen a vascular surgeon (specialist in the treatment of diseases of blood vessels) who has referred you for this procedure.

2. What does the procedure involve?

The procedure is performed in the Vascular X-ray department by a radiologist (x-ray doctor).  Local anaesthetic is used to numb the skin and a small tube is placed in the artery in the groin, this is the only uncomfortable part of the procedure.  Occasionally, it may not be possible to use the groin artery, in which case the artery in the elbow is used.  Under x-ray guidance the tube is passed into position.  A series of pictures are then taken of the arteries by injecting x-ray dye (contrast) into the tube.  The contrast will give you a warm feeling each time it is injected and may give you the feeling of passing water.  Do not be alarmed, this is normal.

3. Do I need to come into hospital for the procedure?

The procedure can often be performed as a day case or as an outpatient.  You will be asked to come to the ward or directly to the X-ray department on the morning of the procedure and will be allowed home a few hours after it has been performed.  On the day of the procedure you should eat and drink as normal and take any regular medication you would normally have.  If you are a diabetic on insulin, please have your normal food and insulin dose. 

You will be seen a few weeks before the procedure in the pre-admission assessment clinic to see if it is appropriate for you to have the procedure as an outpatient.  If not, arrangements will be made for you to be admitted to the ward and stay overnight for the procedure.

5. What happens after the procedure?

Once the bleeding has stopped you will need to remain in bed for half-an-hour and then be allowed to sit out for another half-an-hour.  Whilst you are in bed it is important that you lie relatively still to reduce the risk of bleeding.  If all is well, you will be allowed to go home.

If your procedure is being performed as an outpatient you must have

• someone who can pick you up and take you home
• an adult staying with you overnight at home
• a telephone at home.

 
If you are an inpatient a nurse will escort you back to the ward after the procedure.

Your surgeon will then see you in clinic with the results of the procedure and discuss if any treatment can be offered.

6. Are there any risks with the procedure?

There are potential complications associated with any procedure.  The overall risk of this procedure is extremely low.  The potential risks can be divided into the following categories:

i). At the puncture site

• Some bruising is common after an artery puncture.
• Very rarely significant bleeding from the artery or blockage of the artery can occur which may require a small operation.

The risk of requiring an operation is less than 1%

ii). Related to the contrast

• Some patients experience an allergic reaction to the X-ray contrast.  In most cases this is minor but very rarely (1 in 3000) a reaction may be severe and require urgent treatment with medicines.
• The x-ray contrast can, in some patients, affect the kidney function.  If you are likely to be at risk of this, special precautions will be taken to reduce the chances of this problem occurring.  If you are a diabetic on Metformin tablets, you should not take this on the day of the procedure and for 48 hours after the procedure.

iii). Other complications

• If the artery in the elbow is used, the tube will pass one or more of the arteries supplying the brain.  There is a very small risk that a blood clot could form and cause a stroke (1-2%).

7. Is there anything I can do to help?

You cannot do anything to relieve the actual narrowing or blockage.  However, you can improve your general health by taking regular exercise, stopping smoking and reducing the fat in your diet.  These actions will help slow down the hardening of the arteries which caused the problem in the first place and may avoid the need for further treatment in the future.