Cerebral Angiogram - Outpatient HF#5008

  

 

What Is It?

 

A cerebral angiogram is a test to look at the blood vessels in your brain.  It is a test in which we take a series of x-ray pictures (fluoroscopy) with the use of  (x-ray dye) contrast. The contrast allows the doctor to see the blood vessels (arteries) in your neck and head on TV screens in real time.  The test often lasts 1-2 hours.

 

Why Do You Need an Angiogram?

 

This test is used to check the blood flow through an artery.  Your doctor may want you to have this test to check blood flow before surgery or to look for an area of blockage.

 

Lab tests needed before the angiogram

 

You will need the following labs drawn within 30 days of your angiogram: CBC(complete blood count), platelet count, PTT (partial thromboplastin time), INR(prothrombin time), electrolytes, BUN (body fluid urea) creatinine, glucose.  The results need to be faxed to our office at 608-265-8637 Attn: NES clinical team.  We need these results at least 1 day before the angiogram.  If we do not have these lab results, we may need to reschedule your test.

 

What Should I Do to Get Ready?

 

Certain medicines can affect your body’s ability to clot.  Please be sure your doctor is aware of the medicines you are taking before your angiogram is scheduled.  The only medicine that affects clotting that must be stopped before the angiogram is Coumadin^Ò  (warfarin).  Sometimes, patients may need to be hospitalized for a few days before the angiogram if they are taking Coumadin^Ò so we can safely switch you over to a different blood thinner.  Do not stop taking Coumadin^® without first talking with your doctor.

 

Tell us about your allergies.  Let us know if you are allergic to x-ray dyes, IV contrast, iodine, antibiotics, anesthetic agents, latex, or any other medicines that you may have taken before.

 

Let us know if you have sleep apnea or use a machine at night when you sleep.  This is important to know so we can safely use medicines that make you sleepy during the procedure.

 

Let us know if you have had any fever or pain in the week before your angiogram.  We also need to know if you have had any procedures or tests in the month before your angiogram.

 

Make plans to have someone drive you home after the test.  You can NOT drive for 24 hours after the test.  Plan to have someone stay with you that night, just in case any problems occur and you need care right away.

 

Day of the Test

 

The morning of the test, do not eat solid foods or milk for 6 hours before the exam. Do not drink clear liquids (anything you can see through) less than 2 hours before the exam.  On the morning of the test, you may take your oral medicines with small sips of water unless your doctor or nurse has told you otherwise.

 

If you have diabetes and take insulin, we ask you to take one half (1/2) of your normal morning dose on the day of the test.  If you take a medicine called Glucophage (metformin) you should NOT take it the morning of the angiogram.  You will not take this medication for 48 hours after the angiogram.  Please tell your doctor if you are taking any oral diabetes medicines.

 

Check in at the Radiology clinic desk on the 3rd floor in the atrium lobby area.

 

A nurse will take you to the Radiology prep area.  You will be asked to change into a hospital gown and remove all undergarments.  A nurse will listen to your heart and lungs and make sure you are in good shape to have the test.  An IV will be started in your arm to provide fluids.  A small tube may be placed into your bladder to drain urine since you will not be able to get up to go to the bathroom during or after the test.  We may need extra blood or urine tests before your angiogram and will get them at that time.

 

A doctor (a neuroradiologist) will go over details of the angiogram with you and answer any questions you might have. 

 

When it is time for your angiogram, you will be taken to a special room (the angio suite).  You will lie flat on a table that moves.  The nurse will connect monitors to watch your heart rate, breathing, and blood pressure.  You will be given medicine to make you sleepy.  Once you are ready, the groin area just above your leg (near the hip bone and inner thigh) will be shaved and then cleansed with a liquid that may feel very cold.  You will be covered by sterile sheets and an anesthetic will be used to numb that site before the small tube (catheter) is placed into the artery.

 

During the Test

 

During the test, you will need to lie very still to get the best results.  As the catheter is guided through your blood vessels, the path will be checked by x-rays.  Once the catheter is in place, there will be several injections of x-ray dye.  You may have a warm feeling on the side of your neck and face, lasting 30-60 seconds.  This is normal.  The clicking noise you hear from the x-ray machines is normal.  You may also notice the lights in the room turning on and off.  The doctors and staff step out of the room for a short time while the x-rays are being taken.  At any time during the test, if you feel uncomfortable or short of breath, tell your doctor.

 

After the Test

 

Once the angiogram is done, the catheter will be removed and firm pressure placed on the area for about 15-30 minutes to prevent bleeding.  You will then be taken to a room in Radiology where you will stay for the next 2-6 hours for your recovery.  During that time, you will need to keep your leg straight.  You may roll side to side with help from your nurse.  A nurse will check your blood pressure, pulse, and the catheter site.  You will also be asked to drink plenty of fluids to help flush the dye from your system.  After this time, you will be helped to get up and walk.  If you feel okay, you will then go home.  Keep in mind, you must have a responsible adult to review the discharge instructions and drive you home. You should not drive or make important decisions until the next day.

 

 

Drink 10-20 glasses of fluid for the first 24 hours.  Do not drink any alcohol during this time.

 

You may remove the bandage over the groin the next day and gently wash the area with a mild soap and water.  Do not rub this area to dry the skin.  You should only ‘blot’ the area with a towel.

 

If bleeding occurs at the puncture site, apply direct pressure and go to the nearest emergency room.

 

Activities for the Next Week

 

• You will be allowed to shower the day after the angiogram, but do not soak in a bath tub or hot tub.
• You should not do any heavy lifting (over 10 pounds).
• No vigorous activity.
• No swimming.
• You may remove the bandage over the groin the next day and gently wash the area with a mild soap and water.  Do not rub this area to dry the skin.  You should only ‘blot’ the area with a towel.

 

Be sure to let us know if you will need a letter for work or school to excuse you from these activities.

 

What to Expect

 

• The puncture site might be tender or sore.  This often goes away after a few days, but it can last up to one week.
• You may notice some bruising in your groin.  This goes away after 2-3 weeks.
• Some patients feel a small hard bump about the size of a peanut at the groin site.  This is normal and generally goes away after several months.

 

When to Call the Doctor

 

• If puncture site becomes red and/or hot.

• If any yellow or green drainage comes from site.

• If swelling occurs at the site.

• If your temperature goes above 100°F.

• If you have severe pain or spasm in the leg.

• If numbness or tingling occurs in foot or leg.

• If itching, hives, or rash appear.

 

Phone Numbers

 

If you have any additional questions and/or concerns either before or after your angiogram, after reading this handout, call Neuro Interventional Radiology at (608) 263-8355 between 8:30am and 4:00pm Monday through Friday.

You can also call the Neuroendovascular Nurse at  608-263-4730, during normal business hours.

 

After hours, nights, weekends, and holidays call (608) 262-0486.  This will give you the paging operator.  Ask for the neuroradiology doctor on call.  Give the operator your name and phone number with the area code.  The doctor will call you back.

 

If you live out of the area, please call, 1-800-323-8942.

 

Additional Information

 

On occasion, outpatient diagnostic procedures (i.e.: your angiogram) may need to be rescheduled with little to no notice due to unforeseen emergencies.  We will do everything possile to keep your appointment on the day it was scheduled.

 

Your Angiogram is on__________________________________.

 

Arrive at the Radiology Clinic at____________________________________.

 

 

 

Your follow up appintment in the surgery clinic with DR ___________________is scheduled for ______________at ________________.

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 12/10/2012

Copyright © 09/05/2012 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#5008

Print Health Fact For You