CIENCIASMEDICASNEWS: Peripheral Angiogram

martes, 26 de junio de 2012

Peripheral Angiogram

Peripheral Angiogram

What is a peripheral angiogram?A peripheral angiogram is a test that uses X-rays to help your doctor find narrowed or blocked areas in one or more of the arteries that supply blood to your legs. The test is also called a peripheral arteriogram.
Quick facts

Doctors use peripheral angiograms to help find out if you have peripheral artery disease (PAD). In PAD, fatty deposits (atherosclerosis) narrow or block the arteries that carry blood to your legs.
PAD causes pain, so-called “claudication,” which is discomfort or a tired feeling in your calves, thighs or buttocks (hips) when you exercise. The pain goes away when you rest.
If you have PAD, you may need a peripheral angioplasty or surgery to bypass or open up the narrowed or blocked arteries. Medicine can lessen the pain and discomfort.

Why do people have peripheral angiograms?Doctors use a peripheral angiogram if they think blood is not flowing well in the arteries leading to your legs or, in rare cases, to your arms. The angiogram helps you and your doctor decide if a surgical procedure is needed to open the blocked arteries. Peripheral angioplasty is one such procedure. It uses a balloon catheter to open the blocked artery from the inside. A stent, a small wire mesh tube, is generally placed in the artery after angioplasty to help keep it open. Bypass surgery is another procedure. It re-routes blood around the blocked arteries.

What are the risks of peripheral angiograms?Serious risks and complications from peripheral angiograms are very unlikely. But in rare cases:

A thin tube (catheter) that doctors insert into your artery during a peripheral angiogram damages the artery. Emergency surgery may be needed to restore blood flow to the artery.
People have allergic reactions to the dye used in the test. Tell your doctor if you are allergic to dyes, iodine or shellfish.

How do I prepare for a peripheral angiogram?

Your doctor will give you instructions about what you can eat or drink during the 24 hours before the test.
Usually you’ll be asked not to eat or drink anything for 6 to 8 hours before your peripheral angiogram.
Tell your doctor about any medicines (including over-the-counter, herbs and vitamins) you take. He or she may ask you not to take them before your test. Don’t stop taking your medicines until your doctor tells you to.
Tell your doctor or nurse if you are allergic to anything, especially iodine, shellfish, latex or rubber products, medicines like penicillin, or X-ray dye.
Leave all of your jewelry at home.
Arrange for someone to drive you home after your angiogram.

What happens during the peripheral angiogram?A doctor with special training performs the test with a team of nurses and technicians. The test is performed in a hospital or outpatient clinic.

Before the test, a nurse will put an IV (intravenous line) into a vein in your arm so you can get medicine (sedative) to help you relax. You’ll be awake during the test.
A nurse will clean and shave the area where the doctor will be working. This is usually an artery in your groin.
A local anesthetic will be given to numb the needle puncture site.
The doctor will make a needle puncture through your skin and into your artery, and insert a long, thin tube called a catheter into the artery. You may feel some pressure, but you shouldn’t feel any pain.
The doctor will inject a small amount of dye into the catheter. This makes the narrowed or blocked sections of your arteries show up clearly on X-rays. The dye may cause you to feel flushed or hot for a few seconds.
A peripheral angiogram usually takes 1 to 3 hours from the time you arrive until the catheter is removed.

“I watched the whole thing on the screen. It was a pretty easy procedure.” Shirley, age 77

What happens after the peripheral angiogram?

You will go to a recovery room for 6 to 8 hours.
To prevent bleeding, the nurse will put pressure on the puncture site. After about 45 minutes, the nurse will remove the pressure and check for bleeding.
The nurse will ask you not to move the leg used for the catheter.
The nurse will continue to check often for bleeding or swelling.
Before you leave, the nurse will give you written instructions about what to do at home.

What happens after I get home?

Drink lots of liquids to make up for what you missed while you were preparing for the angiogram and to help flush the dye from your body. For most people, this means drinking at least 6 glasses of water, juice or tea.
You can start eating solid food and taking your regular medicines 4 to 6 hours after your angiogram.
Don’t drive for at least 24 hours.
The puncture site may be tender for several days, but you can probably return to your normal activities the next day.
Your doctor will get a written report of the test results to discuss with you.

What should I watch for?A small bruise at the puncture site is common. If you start bleeding from the puncture site, lie flat and press firmly on that spot. Ask someone to call the doctor who did your peripheral angiogram.
Call your doctor if:

Your leg with the puncture becomes numb or tingles, or your foot feels cold or turns blue.
The area around the puncture site looks more bruised.
The puncture site swells or fluids drain from it.

Call 9-1-1 if you notice:

The puncture site swells up very fast.
Bleeding from the puncture site does not slow down when you press on it firmly.

What can I do to help myself? The most important steps you can take are:

Quit smoking. Avoid secondhand smoke.
Be physically active. Walk, ride a bicycle, or do other types of moderate physical activity for at least 30 minutes five days a week.
Know your blood pressure numbers. Work with your doctor to reach a blood pressure of less than 120/80 mm Hg.
Lower your blood cholesterol levels by eating healthy foods (high in fiber and low in saturated fat, trans fat and cholesterol) and taking your cholesterol lowering medicine. Keep your LDL “bad” cholesterol below 100 mg/dL. People who are at very high risk for coronary heart disease may benefit from lowering LDL cholesterol below 70 mg/dL.
If you have diabetes, work with your doctor to keep your blood sugar under control and reach and maintain an HbA1c of less than 7 percent. HbA1c (hemoglobin A1c) is a blood test that measures your average blood sugar level for the previous 2 to 3 months.
If you are overweight, set your initial goal at a loss of 5 to 10 pounds. If you need to lose more, a weight loss of 1 to 2 pounds per week is recommended until you reach a healthy weight. Visit our Losing Weight website for more information.
If you drink alcohol, have only 1 drink a day if you’re a woman, 2 if you’re a man. Learn more about alcohol and heart disease.