Peripheral vascular disease causes blocked or narrowed arteries in the neck, arms, legs and abdomen. These blocked or narrowed blood vessels can cause strokes, leg pain, kidney problems and high blood pressure. Your doctor will want to take your medical history, give you a physical exam and give you other tests before deciding which treatment is best for you.

He or she will often recommend an angiogram (special X-ray images). This is a procedure that lets your doctor see how well blood flows in your arteries. Your doctor will make a small puncture site in your groin or arm. He or she will insert a sheath (thin, flexible tube) into a major blood vessel through the puncture site. From this site, special catheters can be advanced to the area of interest and dye can be injected. This process is known as angiography. From these special X-rays, your doctor can plan your treatment.

Before the procedure you will meet with a peripheral vascular specialist to talk about risks and benefits. These specialists are cardiologists who are also trained to treat peripheral vascular disease.

A few weeks before your procedure:

• Tell your doctor if you have:
  • any bleeding or if you take any blood thinning medicines
  • diabetes. Your diet, medicine or insulin needs may need to be changed.
  • an allergy to any X-ray dye, iodine, or seafood
  • kidney problems. You may need to do some special preparations.
    
    
• Your doctor may want you to have some tests, such as an ultrasound, electrocardiogram, chest X-rays or blood tests. The tests will usually be arranged before your procedure. Test results will be sent to Minneapolis Heart Institute (MHI) and your vascular specialist before your procedure.

The day of your procedure:

• Do not eat or drink anything for 6 hours before the procedure.
  
  
• Take your regular medicines with small sips of water the morning of the procedure, unless your doctor tells you otherwise.
  
  
• Go to the Day Angiogram admitting desk in the Piper Building (on the northeast corner of the campus, on the corner of 26th Street and 10th Avenue; Choose from the following links to view maps and directions or a campus guide.)
  
  
• The nurse will shave the area where the sheath will be inserted.
  
  
• Blood work will be taken, if needed.
  
  
• A 12-lead ECG (electrocardiogram) will be done to record how well the electrical system of your heart is working, if necessary.
  
  
• You will have forms to complete.
  
  
• A doctor will explain the procedure to you, if you have not already talked with a doctor. (A different doctor may perform the actual procedure.)
  
  
• The nurse will start an intravenous (IV) line in your hand or arm. You will receive fluids and medicine through the IV. The medicine will help you relax. (You will not be put to sleep.)

• You will receive a local anesthetic (medicine injected at the site) so you do not feel any pain.
  
  
• Your cardiologist will place a sheath into an artery in your groin or arm. He or she will thread the catheters through the sheath.
  
  
• Your cardiologist/vascular specialist will guide the catheter to the blood vessel to be studied. You won’t be able to feel the catheter moving. Your cardiologist will watch the progress of the catheter on a monitor next to your bed.
  
  
• When the catheter is in the right spot, your cardiologist/vascular specialist will inject a dye through the catheter. The dye allows your cardiologist/vascular specialist to view your arteries on a special X-ray picture (angiogram). You may be asked to cough a few times after the dye is injected.
  
  
• The X-ray tube will move around you. Your cardiologist will take several pictures from several different views. You may be asked to hold your breath for 5 to 10 seconds while some of the pictures are being taken.
  
  
• If the cardiologist/vascular specialist determines that an intervention will help you, he or she will perform the procedure. Possible procedures include angioplasty, stenting, atherectomy or thrombectomy.
  
  
• Once the blood flow to the blood vessel is restored, the cardiologist/vascular specialist will remove the catheter. The sheath will usually be removed shortly after.

• You will be moved to a special vascular unit. This place specializes in caring for patients who have had procedures like yours.
  
  
• The nurses will monitor your heart rhythm, blood pressure and puncture site.
  
  
• Please tell a nurse if you feel any:
  • bleeding at the puncture site
  • coolness or pain in your leg
  • pain.
    
    
• You will be on bedrest 3 to 6 hours after the sheath is removed. (You may go home the same day or you may need to stay overnight, depending on what is done.)
  
  
• You may have some blood samples taken to check how well you are doing.
  
  
• You can gradually increase your activity.
  
  
• You will receive instructions on your discharge, medicines, restrictions and follow-up appointments you will need.
  
  
• Call your doctor if you have chest pain or swelling around your groin when you get home. It is common to have bruising on your groin.

• Home Care Following Angiography
• What to Expect: Your Heart Procedure at Minneapolis Heart Institute
• Preparation Instructions for Your Heart Procedure at Minneapolis Heart Institute
• Interventional Procedures: Questions & Answers

Other procedures for this sub-specialty

• Atrial Septal Defect (Hole In Your Heart)or Patent Foramen Ovale Closure
• Atherectomy
• Angiography (and Cardiac Catheterization)
• Coronary Stent Implantation
• Endomyocardial Biopsies
• IntraAortic Balloon
• Mitral Valvuloplasty and Aortic Valvuloplasty