A peripheral angiogram is a diagnostic imaging test used by physicians to visualize the arteries in the limbs, most commonly the legs and feet. This procedure provides a detailed “roadmap” of the blood vessels, allowing doctors to identify areas where blood flow may be restricted. It is typically performed when a patient presents with symptoms suggesting circulation problems outside of the heart and brain. Understanding the steps involved offers clarity on this important diagnostic tool.
What Is a Peripheral Angiogram and Why Is It Performed?
A peripheral angiogram is a specialized X-ray procedure designed to look at blood flow through the peripheral arteries. The test uses a contrast agent, often referred to as a dye, injected directly into the bloodstream to make the vessels visible on X-ray images. The primary reason for this test is to diagnose or assess the severity of Peripheral Artery Disease (PAD). PAD involves the narrowing of arteries, most often in the legs, due to the buildup of plaque (atherosclerosis).
This narrowing reduces the supply of oxygenated blood to the extremities. Patients are referred for an angiogram if they experience symptoms like pain or cramping in the legs during walking (claudication), non-healing sores, or a notable difference in temperature between limbs. By highlighting the arteries, the angiogram helps pinpoint the exact location and extent of blockages. This information determines the most appropriate course of treatment, which could range from medication to a minimally invasive intervention like angioplasty.
Essential Preparation Before the Procedure
Preparing for a peripheral angiogram involves several mandatory steps to ensure patient safety and the accuracy of the imaging. Patients are required to fast, meaning they must not eat or drink anything for six to eight hours before the scheduled time. This prevents complications, particularly if mild sedation is used.
A thorough review of all current medications is required, as some drugs can interact with the contrast dye or increase the risk of bleeding. Physicians provide specific instructions regarding blood thinners, which may need to be stopped or adjusted prior. Patients taking certain diabetes medications, such as Metformin, may also receive special guidance because the contrast agent can affect kidney function. Since the procedure involves sedation and recovery, every patient must arrange for someone to drive them home afterward.
Navigating the Angiogram Procedure: Step-by-Step
The peripheral angiogram is performed in a specialized catheterization laboratory while the patient is often lightly sedated. The procedure begins with the patient lying on an X-ray table, where monitoring devices track heart rate and blood pressure. The medical team cleans and shaves a small area of skin, usually in the groin, wrist, or arm, which is the chosen access point for the artery.
A local anesthetic is injected to numb the site, which may cause a brief stinging sensation. The physician then makes a tiny puncture and inserts a slender, flexible tube called a catheter into the artery through a small sheath. Using real-time X-ray technology called fluoroscopy, the physician guides the catheter through the arterial system until it reaches the area being examined.
Once the catheter is in position, the iodine-based contrast dye is injected through the tube. As the dye travels through the arteries, it makes the blood vessels visible on the X-ray screen, creating a dynamic image of the blood flow. The patient may feel a temporary sensation of warmth or flushing during this injection. The physician captures a series of images to identify the precise locations and severity of any arterial blockages.
After all images are obtained, the catheter is carefully removed. The medical team applies firm pressure to the access site for 10 to 20 minutes to prevent bleeding and allow the artery wall to seal.
Immediate Recovery and Understanding the Results
Following the procedure, the patient is moved to a recovery area for observation to prevent complications at the access site. To minimize the risk of bleeding, patients whose catheter was inserted through the groin are required to lie flat for several hours without bending the leg. Nurses closely monitor vital signs and check the puncture site for any signs of swelling or active bleeding.
Patients commonly experience soreness or bruising at the insertion site for a few days. Post-procedure instructions include drinking plenty of fluids to help flush the contrast dye from the kidneys. Patients are advised to watch for potential signs of complications, such as excessive bleeding that does not stop with pressure, numbness or tingling in the limb, or a change in the limb’s color or temperature. The physician analyzes the angiogram images to determine if blockages require immediate intervention. The ordering doctor typically discusses the full results and next steps within a few days.