Weiss PF, Corao DA, Pollock AN, Finkel TH, Smith SE

Catheter Angiography

Article
Brain & Nerve
Eye & Vision
+6
Contributed byKrish Tangella MD, MBAFeb 05, 2019

Background Information:

What are the other Names for the Procedure?

  • Catheter Angiogram

What is Catheter Angiography radiology procedure? (General Explanation)

  • A Catheter Angiography uses MRI, CT, and x-ray catheters, with a contrast material to produce images of major blood vessels
  • A thin tube, called a catheter, is inserted into the artery. The contrast material is injected through the catheter and images are captured

What part of the Body does the Procedure involve?

A Catheter Angiography procedure is mainly used to check blood vessels in different parts of the body, such as the neck, abdomen, heart, lungs, legs, pelvis, kidneys, and brain.

Why is the Catheter Angiography radiology procedure Performed?

  • An angiogram is mainly used to check blood vessels in different parts of the body, such as the neck, abdomen, heart, lungs, legs, pelvis, kidneys, and brain. It can be used to identify lipid deposits or plaque in the arteries of the brain and legs
  • Angiograms identify arteriovenous malformations in the brain
  • Catheter Angiograms are also used during kidney transplantation, coronary bypass, stent implantation, and to identify injuries in arteries during trauma
  • The procedure can also be used to detect endocrine diseases, pulmonary embolism, and arteries supplying blood to tumors

What is the Equipment used? (Description of Equipment)

The equipment used for a Catheter Angiography procedure consists of the following:

  • A table
  • An X-ray tube
  • A computer monitor

An image intensifier located over the patient lying on the table, converts x-ray into a video image.

What are the Recent Advances in the Procedure?

There have been no recent advances to replace the Catheter Angiography procedure. 

What is the Cost of performing the Catheter Angiography radiology procedure?

The cost of the Catheter Angiography procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.

When do you need a Second Opinion prior to Procedure?

  • It is normal for a patient to feel uncomfortable and confused with a sudden inflow of information regarding a Catheter Angiography procedure and what needs to be done.
  • If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician.
  • Also, if the procedure involves multiple steps or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently.

What are some Helpful Resources?

http://www.radiologyinfo.org/en/info.cfm?pg=angiocath (accessed on 08/02/2014)

Prior to Catheter Angiography radiology procedure:

How does the Catheter Angiography radiology procedure work?

  • A Catheter Angiogram works on similar principles as an x-ray machine
  • X-rays are aimed at different parts of the body and an image is produced on a recording plate, using X-rays that have passed through the body
  • A contrast material, such as barium, is also used to visualize the blood vessels

How is the Catheter Angiography radiology procedure Performed?

The Catheter Angiography procedure is performed as:

  • In the preparation room, a nurse inserts an intravenous (IV) line into the arm
  • A blood sample is drawn in to see that the kidneys are functioning properly
  • The area where the catheter is inserted is shaved and numbed, with an anesthetic
  • The catheter is inserted into the artery, by making a small incision into the skin. The catheter is guided to the area of interest
  • The contrast material is injected through the catheter, to visualize the artery of interest. Several x-ray images are taken
  • The catheter and IV are removed and the incision site is closed. The entire procedure may take anywhere from an hour to several hours to complete

Where is the Procedure Performed?

A Catheter Angiography procedure is performed as an outpatient procedure, at a hospital. 

Who Performs the Procedure?

The following specialists may perform a Catheter Angiography procedure: 

  • Neuro-radiologists
  • Neurosurgeons
  • Pediatric neurosurgeons
  • Vascular and interventional radiologists
  • Vascular neurologists

How long will the Procedure take?

The Catheter Angiography procedure may take between 1-3 hours to perform.

Who interprets the Result?

  • The radiologist or neurologist interprets the images taken from the Catheter Angiography, to determine any blockage of blood flow
  • After the procedure, follow-up visits may be needed

What Preparations are needed, prior to the Procedure?

The following preparations may be needed prior to a Catheter Angiography procedure:

  • The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient, including information related to the medications that are being currently taken
  • Do inform the medical professional if you have a history of any medical conditions, such as a heart disease, asthma, diabetes, or kidney disease
  • Do inform the medical professional about any allergies, especially related to barium or iodinated contrast material, which may be used in the procedure
  • It is advisable to wear comfortable and loose clothes. Avoid wearing any metal objects or jewelry, as it may interfere with the x-ray
  • It is highly recommended to inform your healthcare professional, if you are pregnant or breastfeeding
  • The patient may have to stay at the hospital overnight for observation and may need someone to drive them home, if given any sedatives.

What is the Consent Process before the Procedure?

A physician will request your consent for a Catheter Angiography procedure using an Informed Consent Form.

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.

You must sign the forms only after you are totally satisfied with the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What are the Benefits versus Risks, for this Procedure?

Following are the benefits of the Catheter Angiography procedure:

  • By using this method, it is possible to diagnose and treat the condition at the same time. For example, narrowing of the artery can be fixed by angioplasty and placement of stent, during the procedure
  • It may eliminate the need for surgery
  • It produces very detailed images of the blood vessels
  • The radiation does not stay in the patient’s body after the procedure

Following are the risks of the Catheter Angiography procedure:

  • Over-exposure of radiation may cause cancer; though, this is very rare
  • Contrast materials used in the procedure may cause an allergic reaction in some patients
  • If contrast material leaks out under the skin, it may cause some skin damage
  • Very rarely, a blood clot may form on the tip of the catheter and blocks the artery
  • Internal bleeding may occur, if the catheter punctures the artery; however, this is also a very rare occurrence

What are the Limitations of the Catheter Angiography radiology procedure?

The Catheter Angiography procedure is not recommended for patients with kidney problems or diabetes. 

What are some Questions for your Physician?

Some of the basic questions that you might ask your healthcare provider or physician are as follows:

  • What is the Catheter Angiography procedure?
  • Why is this procedure necessary? How will it help?
  • How soon should I get it done? Is it an emergency?
  • Who are the medical personnel involved in this procedure?
  • Where is the procedure performed?
  • What are the risks while performing the procedure?
  • What are the complications that might take place, during recovery?
  • What are the possible side effects from the procedure? How can I minimize these side effects?
  • How long will it take to recover? When can I resume normal work?
  • How many such procedures have you (the physician) performed?
  • Are there any lifestyle restrictions or modifications required, after the procedure is performed?
  • Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
  • Is there any medication that needs to be taken for life, after the procedure?
  • What are the costs involved?

During the Catheter Angiography radiology procedure:

What is to be expected during the Catheter Angiography radiology procedure?

The following may be expected during the Catheter Angiography procedure:

  • The patient may feel a little pain, when the needle is inserted for the IV line
  • The contrast material used in the procedure may cause a warm sensation
  • As local anesthetic is used at the site of catheter insertion, the procedure is mostly painless
  • The patient may ask for a blanket or pillow, because the x-ray table may feel hard and cold
  • The patient may feel a slight tenderness or bruising at the site of the injection after the Catheter Angiogram

What kind of Anesthesia is given, during the Procedure?

Local anesthesia may be used to numb the area, where the catheter is inserted, during the Catheter Angiogram procedure.

How much Blood will you lose, during the Procedure?

The procedure is a minimally-invasive procedure; hence, the blood loss involved during a Catheter Angiography procedure is minimal.

What are the possible Risks and Complications during the Catheter Angiography radiology procedure?

The possible risks of the Catheter Angiography procedure include:

  • Allergic reaction to the contrast dye
  • Blood clot or bleeding at the needle stick site, which could partly obstruct blood flow to the leg
  • Damage to an artery or arterial wall from the catheter, which can obstruct the blood flow and cause a stroke (in rare cases)

What Post-Operative Care is needed at the Healthcare Facility after the Catheter Angiography radiology procedure?

  • Generally, no significant post-operative care is needed at the healthcare facility, after a Catheter Angiogram procedure
  • However, a short period of observation may be occasionally recommended by your healthcare provider

After the Catheter Angiography radiology procedure:

What is to be expected after the Catheter Angiography radiology procedure?

The following may be expected after a Catheter Angiography procedure:

  • The patient will be transferred to a recovery room and monitored for 4-6 hours, after the Catheter Angiogram before going home
  • The patient should be able to resume their normal activities within 24 hours, after the procedure
  • However, they should avoid driving for a period of 24 hours and lifting heavy objects or climbing stairs, for a period of 48 hours
  • A normal diet can be resumed right after the exam

When do you need to call your Physician?

Do inform your physician or healthcare provider, if the following are noticed after the Catheter Angiography procedure:

  • In case you develop an infection with fever, numbness, and pain
  • Bleeding
  • Chest pain
  • Difficulty walking or talking
  • Dizziness
  • Facial weakness, slurred speech
  • Unusual swelling
  • Vision problems

What Post-Operative Care is needed at Home after the Catheter Angiography radiology procedure?

No specific post-operative care is needed at home after the Catheter Angiography procedure. However, the instructions of the healthcare provider have to be strictly followed. 

How long does it normally take to fully recover, from the Procedure?

  • The patient should be able to resume their normal activities within 24 hours, after a Catheter Angiography
  • They must avoid driving for the next 24 hours
  • They must also avoid lifting heavy objects or climbing stairs for the next 48 hours, if the IVC filter was inserted through a large vein in the groin

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

The Catheter Angiogram procedure does not involve the removal of any body tissue.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

Since no tissue is removed during the procedure, a pathologist does not get involved in the care of the patient.

Who will you receive a Bill from, after the Catheter Angiography radiology procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers.

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

  • The hospital, where the procedure is performed
  • Radiologist, neurologist, or other specialist performing the procedure
  • Healthcare providers, physicians, who are involved in the process

The patient is advised to inquire and confirm the type of billing, before the Catheter Angiography procedure is performed.

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Krish Tangella MD, MBA

Pathology, Medical Editorial Board, DoveMed Team

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