An angiogram is an imaging test that uses X-rays to look at your blood vessels. It is done to check for conditions such as:
- Weak, stretched or enlarged portion of a blood vessel (aneurysm)
- Narrowing of a blood vessel (stenosis)
An abdominal angiogram looks at the blood vessels in your belly (abdomen). It may be used to check blood flow to the organs of the abdomen, such as the liver and spleen. It may also be used to guide in the placement of medicine or other materials to treat cancer or bleeding in the abdomen.
Fluoroscopy is often used during an abdominal angiogram. This is a kind of X-ray "movie" with continuous X-rays showing the provider real time images of the test procedure.
Contrast dye is used to cause the blood vessels to appear solid on the X-ray image. This lets the radiologist see the blood vessels more clearly. Dye is injected into specific blood vessels to look at a certain area of blood flow more closely.
For an abdominal angiogram, a catheter (small tube) is placed into a large artery in your groin and then placed into the specific artery of interest. Contrast is injected through this tube. Next, the radiologist takes a series of X-ray pictures. These X-ray images show the blood flow in the abdomen. You may also have a CT (computed tomography) scan or MRI (magnetic resonance imaging) scan with your angiogram.
You may need an abdominal angiogram to find problems of the blood vessels in the abdomen. Problems include:
- Stenosis or spasms of the blood vessel (vasospasm)
- A connection between the arteries and veins that isn't normal (arteriovenous malformation)
- A blood clot within a blood vessel or blockage of a blood vessel
Other conditions that may be found by include tumors, or bleeding. Angiography may be used to deliver medicine directly into tissue or an organ. This might include clotting medicine to the site of bleeding or cancer medicine into a tumor.
Your healthcare provider may have other reasons to recommend an abdominal angiogram.
You may want to ask your healthcare provider about the amount of radiation used during the test. Also ask about the risks as they apply to you.
Consider writing down all X-rays you get, including past scans and X-rays for other health reasons. Show this list to your provider. The risks of radiation exposure may be tied to the number of X-rays you have and the X-ray treatments you have over time.
Tell your provider if:
- You are pregnant or think you may be pregnant. Radiation exposure during pregnancy may lead to birth defects.
- You are allergic to or sensitive to medicines, contrast dyes, local anesthesia, iodine, or latex
- If you have a history of kidney disease
- If you are breastfeeding to determine if you should wait until after your procedure to continue breastfeeding
Because the procedure involves the blood vessels and blood flow of the abdomen, there is a small risk for complications involving the abdomen. These include:
- Bleeding because of puncture of a blood vessel
- Injury to nerves
- Blood clot in the blood vessel
- Area of swelling caused by a buildup of blood
- Organ damage
You may have other risks depending on your specific health condition. Be sure to talk with your provider about any concerns you have before the procedure.
Tips for being prepared:
- Your healthcare provider will explain the procedure to you. Ask him or her any questions you have about the procedure.
- You may be asked to sign a consent form that gives permission to do the procedure. Read the form carefully and ask questions if anything is not clear.
- Tell your healthcare provider if you have ever had a reaction to any contrast dye, or if you are allergic to iodine.
- Tell your healthcare provider if you are sensitive to or are allergic to any medicine, latex, tape, and anesthesia.
- You will need to fast for a certain period before the procedure. Your healthcare provider will tell you how long to fast, whether for a few hours or overnight.
- Tell your healthcare provider if you are pregnant or think you may be.
- Tell your healthcare provider of all medicines (prescribed and over-the-counter) and herbal supplements that you are taking.
- Tell your healthcare provider if you have a history of bleeding disorders or if you are taking any anticoagulant (blood-thinning) medicines, aspirin, or other medicines that affect blood clotting. You may be told to stop these medicines before the procedure.
- Your healthcare provider may request a blood test before the procedure to find out how long it takes your blood to clot. Other blood tests may be done as well.
- You may get a sedative before the procedure if needed. You may also get an anticholinergic medicine, which acts to slow down the production of saliva in the mouth. It also slows the production of acid in the stomach, and the activities of the intestinal tract, among other effects. If you get this medicine, you may notice that your mouth feels dry.
- Depending on the site used for injection of the contrast dye, the recovery period may last up to 12 to 24 hours. You may need to spend the night.
- Based on your condition, your healthcare provider may ask for other preparations.
You may have an abdominal angiogram as an outpatient or as part of a hospital stay. The way the test is done may vary depending on your condition and your healthcare provider's practices.
Generally, an abdominal angiogram follows this process:
- You will need to remove any clothing, jewelry, or other objects that may get in the way of the test.
- You will be given a gown to wear.
- You will be asked to empty your bladder before the start of the procedure.
- You will be positioned on the X-ray table.
- An intravenous (IV) line will be inserted in your arm or hand.
- You may be connected to a heart monitor that records the electrical activity of the heart and monitors the heart during the procedure. Your vital signs (heart rate, blood pressure, and breathing rate) will be monitored during the procedure.
- The radiologist will check your pulses below the injection site for the contrast dye and mark them with a marker so that the blood flow to the limb below the site can be checked after the procedure.
- A line will be inserted into an artery in your groin after the skin is cleansed and a local anesthetic is injected. Sometimes an artery in the elbow area of the arm may be used. If the groin or arm site is used, the site will be shaved before insertion of the line. If the arm site is used, a blood pressure cuff will be applied to the arm below the site and inflated to prevent flow of the contrast dye into the lower arm.
- Once the needle has been placed, a catheter (a long, thin tube) will be inserted into the artery at the groin or arm site. Fluoroscopy may be used to check the location of the catheter within the abdomen.
- An injection of contrast dye will be given. You may have some effects when the dye is injected into the line. These effects include a flushing sensation, a salty or metallic taste in the mouth, a brief headache, or nausea and/or vomiting. These effects usually last for a few moments.
- Tell the radiologist if you have any breathing trouble, sweating, numbness, or heart palpitations.
- After the contrast dye is injected, a series of X-rays will be taken. The first series of X-rays shows the arteries, and the second series shows capillary and venous blood flow.
- There may be one or more injections of contrast dye.
- The catheter will be removed and pressure will be applied over the area to keep the artery from bleeding.
- After the site stops bleeding, a dressing will be applied to the site. A sandbag or other heavy item may be placed over the site for a time to prevent further bleeding or the formation of a hematoma at the site.
After the procedure, you will be taken to the recovery room for observation. Medical staff will watch the blood flow and feeling in your leg where the injection catheter was inserted. A nurse will check your vital signs and the injection site.
You will stay flat in bed in a recovery room for several hours after the procedure. The leg or arm on the side of the injection site will be kept straight for up to 12 hours.
You may be given pain medicine for pain or discomfort of the injection site.
You will be urged to drink water and other fluids to help flush the contrast dye from your body.
You may go back to your usual diet and activities after the procedure, unless your healthcare provider advises you otherwise.
After recovery, you may go back to your hospital room or discharged to your home. If this procedure was done as an outpatient, plan to have someone drive you home.
Once at home, you should check the injection site for bleeding. A small bruise is normal, as is an occasional drop of blood at the site.
Watch the leg or arm for changes in temperature or color, pain, numbness, tingling, or loss of function of the limb.
Drink plenty of fluids to prevent dehydration and to help pass the contrast dye.
You may be told to avoid heavy activity and not to take a hot bath or shower for a period of time after the procedure.
Call your healthcare provider right away if any of these happen:
- Fever or chills
- Increased pain, redness, swelling, or bleeding or other drainage from the groin injection site
- Coolness, numbness and/or tingling, or other changes in the affected arm or leg
Your healthcare provider may give you other instructions after the procedure, depending on your situation.
Before you agree to the test or the procedure make sure you know:
- The name of the test or procedure
- The reason you are having the test or procedure
- What results to expect and what they mean
- The risks and benefits of the test or procedure
- What the possible side effects or complications are
- When and where you are to have the test or procedure
- Who will do the test or procedure and what that person’s qualifications are
- What would happen if you did not have the test or procedure
- Any alternative tests or procedures to think about
- When and how will you get the results
- Who to call after the test or procedure if you have questions or problems
- How much will you have to pay for the test or procedure
January 11, 2018
Grossman, Neil, MD,Hanrahan, John, MD