All age-groups can be examined, but in some cases sedation or general anaesthesia may be necessary. A parent’s written consent is necessary in case of an underage patient, of next of kin, guardian or the referring physician in case of unconscious or non compos mentis patients.
According to the complaints or when control examinations are required.
Applying modern technology angiography is a safe method. However, there are risk factors as a catheter is introduced into the vein through which contrast material is injected. After the procedure, hematoma formation is common at the puncture site. This will absorb soon. During the passage of the catheter, the vein wall may be damaged, bleeding or occlusion may develop. Serious complications (shock, death) are extremely rare. In these cases, generally there are underlying diseases of multiple vital organs at the same time.
During pregnancy, the intervention is only performed with a suspected severe disease, as X-ray may be harmful for the foetus.
Referral of a specialist (not a general practitioner) is needed for the examination.
Allergy to contrast materials is a rare side-effect and it is mostly mild (nausea, rash, shivering, drop in blood pressure). The mild symptoms will disappear in a few minutes or can be easily stopped with medication. Hypersensitivity with respiratory and circulatory failure is extremely rare. In this situation intensive care is required and could lead to the death of the patient. For your safety, medication, equipment and the necessary clinical background for treating hypersensitivity to contrast materials are provided.
Depending on the conditions of the opreation room the examination is performed in recumbent position. The catheter is most often introduced through the artery of the groin or arm following by local anesthesia at the introduction site. The catheter is stopped at the beginning of the vessel to be examined, and the contrast material is directly injected into that vessel. The modern contrast materials used in our institutions do not strain the body, and are eliminated through the urine. Images are taken during the examination. After the images are taken, the catheter is removed.
Certain medications should be stopped for a few days before the examination (e.g. Syncumar, medications containing mercformin for the treatment of diabetes). Other medications can be taken as usual. It is usually necessary to arrive at the hospital in the morning of the pocedure wearing light clothes. Jewelery should be left at home. It is not allowed to eat 4-6 hours before the angiography. It is recommended to drink an abundant amount of liquids the day before the examination. If the patient is more worried of the angiography than usual, after consulting with the physician he or she may take a light sleeping pill or sedative the night before the examination. Urination and defecation are to be done before the examination to avoid the unpleasant situations.
A few laboratory tests are necessary: blood test, bleeding time, coagulation time, prothrombin level, kidney function. The physician must be informed about allergy to any medication (e.g. local anaesthetics), contrast material or iodine. Right before the examination, patient information should be read and consent form should be signed in the preparation room of the angiographic laboratory. False teeth should be removed for the time of the procedure.
The examination usually takes 40-60 minutes including preparation.
Pressure is applied to the puncture site till the bleeding stops, and then a pressure-bandage is used for 6-24 hours depending on the puncture location and the thickness of the catheter. If the catheter is introduced through the groin artery, strict bed rest is necessary for at least 24 hours after the examination.
After the intervention, to ensure the quick elimination of the contrast material abundant liquid should be consumed. The physician will let the patient leave the hospital depending on the clinical condition. Smoking is prohibited for at least 24 hours. Lifting heavy weights or driving are prohibited for two days. An ambulance should be immediately called if there is bleeding at the puncture site or the catheterized limb becomes painful or discolours.
On the whole, the intervention can be concidered inconvenient rather than painful. Administration of the local anaesthetic injection is accompanied by a painful, straining and stinging sensation, just like other injections. Injection of the contrast material is accompanied by a warm sensation where the contrast material passes by. It can cause a hot, painful or a pleasant warm sensation depending on the illness.
The physician will receive the medical report a few hours after the examination. If consultation is needed, this period may be longer.