Angiogram Surgeon in Maryland, New Jersey, and Virginia

An angiogram, combining "angio" (relating to blood vessels) and "gram" (a record or picture), is a diagnostic procedure to visualize arteries and assess blood flow. Center for Vascular Medicine specializes in angiograms to diagnose and treat Peripheral Arterial Disease (PAD), a condition characterized by plaque buildup in the arteries that restricts blood flow.

During the procedure, medicine is administered through an IV to keep the patient comfortable yet awake. A local anesthetic is applied where the needle or sheath is inserted into the artery to minimize discomfort.

A catheter is threaded through the sheath and inserted into the artery. Dye is injected through the sheath, making the arteries visible on an X-ray monitor. Patients might experience a warm or burning sensation when the dye is injected and must remain still to ensure clear imaging of the arteries.

Intravascular Ultrasound (IVUS) might be used to gather detailed information about the plaque or blockage inside the artery. This advanced imaging technique provides a comprehensive view of the arterial condition.

Why Would I Need an Angiogram?

An angiogram is a crucial diagnostic tool for identifying and assessing various vascular conditions, particularly Peripheral Arterial Disease (PAD). PAD occurs when plaque builds up in the arteries, causing them to narrow and harden. This can significantly reduce blood flow and oxygen delivery to essential body parts, including the legs, arms, head, kidneys, and stomach.

Diagnosing Peripheral Arterial Disease (PAD)

Peripheral Arterial Disease is a common condition that can lead to severe complications if left untreated. It primarily affects the arteries in the legs but can also impact other major arteries. PAD is characterized by the accumulation of cholesterol and plaque on the arterial walls, a process known as atherosclerosis. Over time, this buildup can restrict blood flow, leading to various symptoms and health issues. The main symptom of PAD is leg pain caused by insufficient blood flow, which can occur during physical activity (claudication) or even at rest.

Assessing the Severity of Arterial Blockages

An angiogram provides detailed images of the blood vessels, allowing doctors to evaluate the severity and location of blockages. This information is vital for planning appropriate treatment strategies. The procedure helps determine the extent of arterial narrowing and identifies specific areas where blood flow is restricted.

Identifying and Treating Aneurysms

Angiograms can also diagnose aneurysms, which are abnormal bulges in the walls of blood vessels. If an aneurysm is detected, immediate medical intervention is required to prevent it from rupturing, which can lead to life-threatening complications. The angiogram helps visualize the aneurysm and plan the necessary surgical or endovascular treatment.

Evaluating Vascular Health Before Surgery

An angiogram may be necessary to assess a patient's vascular health before undergoing certain types of surgery, particularly those involving the heart or major blood vessels. This ensures that any underlying vascular issues are identified and managed before the surgery, reducing the risk of complications during and after the procedure.

Monitoring Post-Surgical Progress

Patients who have undergone vascular surgery or angioplasty may need angiograms to monitor the success of the treatment and to check for any signs of re-narrowing or new blockages. This follow-up imaging is crucial for ensuring that the arteries remain open and that blood flow is adequately restored.

Investigating Symptoms of Vascular Disease

Symptoms such as unexplained chest pain, shortness of breath, leg pain, or numbness can prompt a doctor to recommend an angiogram. These symptoms may indicate underlying vascular problems that must be identified and treated promptly. The angiogram helps pinpoint the exact cause of the symptoms and guides the treatment plan.

An angiogram is an essential diagnostic procedure for evaluating and treating various vascular conditions. At Center for Vascular Medicine, angiograms play a pivotal role in diagnosing Peripheral Arterial Disease, assessing the severity of arterial blockages, identifying aneurysms, evaluating vascular health before surgery, monitoring post-surgical progress, and investigating symptoms of vascular disease. This comprehensive approach ensures patients receive accurate diagnoses and effective treatments, improving their overall vascular health and quality of life.

How Can I Prepare for an Angiogram?

A detailed history is essential, including primary medical history with risk factors like high blood pressure, previous surgical history, and social history concerning tobacco or nicotine use. Assessing the patient's symptoms is critical, alongside a thorough physical examination. This examination includes evaluating the pulses in the affected extremity, the temperature and color of the extremity, and checking for slow or non-healing wounds or ulcerations. Various tests are conducted to rule out other possible vascular conditions. The angiogram procedure at Center for Vascular Medicine is minimally invasive and typically performed on an outpatient basis, requiring no hospital stay and allowing for a quick recovery.

Initial Diagnostic Testing:

Initial diagnostic testing involves a Duplex (Ultrasound) study of the extremities to visualize blood flow and Ankle-Brachial Index (ABI) readings to measure blood pressure in the lower extremities. These tests help assess the severity of arterial blockages and plan further treatment.

Will I Require Anesthesia for an Angiogram?

During the procedure, medicine is administered through an IV to keep the patient comfortable yet awake. A local anesthetic is applied where the needle or sheath is inserted into the artery to minimize discomfort.

A catheter is threaded through the sheath and inserted into the artery. Dye is injected through the sheath, making the arteries visible on an X-ray monitor. Patients might experience a warm or burning sensation when the dye is injected and must remain still to ensure clear imaging of the arteries.

Intravascular Ultrasound (IVUS) might be used to gather detailed information about the plaque or blockage inside the artery. This advanced imaging technique provides a comprehensive view of the arterial condition.

Treatment Options Post-Angiogram

Once the plaque is identified, Center for Vascular Medicine offers several treatment options. An atherectomy involves using a device to remove or reduce the plaque inside the artery.

Angioplasty employs a tiny balloon inserted through the sheath and inflated to flatten the plaque against the artery wall. Once the artery is opened, the balloon is deflated and removed. Stent placement involves inserting a small metal or mesh tube to keep the artery open. The stent acts as a scaffold, supporting the artery and ensuring proper blood flow.

What Can I Expect During Recovery?

Depending on the procedure's specifics, recovery in an office setting typically ranges from 2 to 4 hours. Advanced medical technology and minimally invasive techniques at Center for Vascular Medicine facilitate a smooth recovery, ensuring the best outcomes for patients with PAD and other vascular conditions.

Activity Restrictions:

After the procedure, patients should avoid heavy lifting, straining, and impact exercises for the first five days. Walking and climbing steps are allowed if there’s no excessive bruising or swelling at the puncture site. Patients can resume driving the day after the procedure.

Puncture Site Care:

The dressing over the puncture site should be kept for three days. Patients should inspect the site daily for any significant changes and avoid soaking in a bathtub, hot tub, or pool until it heals. If there is bleeding or swelling, immediate medical attention is required.

Monitoring:

Bruising around the puncture site might only appear a few days after the procedure. Patients should monitor for any unusual symptoms and seek help if necessary. Regular follow-up with the physician ensures a smooth recovery.

Choosing Center for Vascular Medicine for angioplasty offers numerous benefits. The minimally invasive procedure does not require a hospital stay and has a short recovery period. Most patients can return to normal activities within a few days. The continuity of care and higher levels of individual patient care in an outpatient setting enhance the patient experience. Outpatient procedures generally have lower infection rates, and the small incision used to access the artery minimizes scarring and recovery time.

Are There Risks Associated With The Angiogram Procedure?

While angiograms and related procedures are generally safe, they carry some risks. Any procedure involving catheter placement in a blood vessel carries risks such as damage to the blood vessel, bruising, bleeding, or infection at the puncture site, though the risk is less than one percent.

Allergies to the X-ray contrast material used during the procedure can range from mild itching to severe reactions. Patients with known allergies are pre-treated to reduce this risk, and medications to counteract allergic reactions are kept on-site.

X-ray exposure during endovascular procedures is typically well below levels that would cause adverse effects. However, patients with poor kidney function are at a higher risk of adverse effects from the dye. Your vascular specialist will order blood work to identify at-risk patients and administer IV fluids to help utilize the dye safely. In some cases, CO2 may be used instead of dye.

Medication Risks

Certain medications can increase the risk of bleeding from the puncture site. Blood thinners like Xarelto, Eliquis, Pradaxa, Coumadin (Warfarin), Heparin, and Lovenox can pose a higher risk. Patients will receive specific instructions on a case-by-case basis. Aspirin, Plavix, Cilostazol, and Aggrenox can generally be continued as prescribed, with some adjustments on the procedure day. Diabetic medications will also be adjusted accordingly.

Risks During the Procedure

The duration of the procedure depends on the extent of plaque buildup, ranging from 45 minutes to several hours. Patients should be prepared to spend most of the day at the facility to ensure optimal outcomes and safe recovery. Continuous monitoring of the patient’s blood pressure, heart rate, and breathing ensures safety throughout the procedure. The goal is to keep the patient comfortable while adjusting medications based on comfort levels and vital signs.

Angiogram Procedure at Center for Vascular Medicine

Patients benefit from expert care, advanced technology, and a patient-centered approach to treating Peripheral Arterial Disease and other vascular conditions by choosing Center for Vascular Medicine. This comprehensive care model ensures that each patient receives personalized treatment tailored to their needs, enhancing their overall health and quality of life.