Angiogram

An angiogram is a diagnostic test that uses X-ray radiation and contrast material (a substance that looks opaque on X-rays) to produce images of the blood vessels in the body. To take an angiogram, a long, flexible catheter is inserted into one of your body’s large blood vessels, such as the femoral artery in the groin. The doctor performing the angiogram injects contrast material through the catheter into the bloodstream, making the vessel visible on the X-ray monitor (known as a fluoroscope). Guided by live-action images, the doctor advances the catheter through the vessel to the area to be examined, then injects more contrast and takes a series of images for purposes of diagnosis and evaluation.

An angiogram can help diagnose a stroke, aneurysm, blood clots, narrowing of the arteries due to plaque build-up, arteriovenous malformation (an abnormal connection between arteries and veins, also known as AVM), tumors and other conditions.

Other less invasive imaging technologies can also provide views of blood vessels—for instance, neither computed tomography angiography (CTA) nor magnetic resonance angiography (MRA) require the insertion of a catheter. However, in certain circumstances, angiograms can offer advantages over those less-invasive approaches. For instance, in cases where a patient may need angioplasty (in which a tiny balloon at the end of a catheter is inflated to open a blocked artery) or the placement of a stent (a small tubular support that holds an artery open), catheter angiography allows for both diagnosis and treatment.

When it comes to an angiogram, the radiologists at Northwell Health Imaging are the power behind the exam. Every angiogram is performed with state-of-the-art technology and interpreted by a fellowship-trained cardiothoracic radiologist whose diagnostic skills have been honed by specialized training and thousands of hours of experience. If you need additional care, your radiologist will work side by side with the rest of your cardiac care team, collaborating closely to answer your questions and help guide your care.

Northwell Health Imaging offers the largest group of fellowship-trained and subspecialized radiologists on Long Island, as well as access to all the resources and clinical expertise of New York state’s largest health system. Whether you are here for screening, diagnostic or treatment imaging services, each of our practitioners is committed to providing a caring, comfortable environment and a positive, productive experience.

An angiogram is an invasive procedure and carries some risks, although major complications are rare.

Because X-rays are used to monitor the progress of the catheter, as well as to create images of the area being examined, an angiogram involves somewhat higher radiation exposure than many other X-ray exams. Excessive radiation exposure can raise the risk of cancer.

There is a small risk of the catheter damaging the artery, or dislodging plaque lining the artery wall. If plaque is loosened, it could obstruct blood flow and cause a stroke or heart attack, depending on where the obstruction occurs.

Rarely, people have an allergic reaction to the contrast material. If you have diabetes or kidney problems, the contrast material could also cause kidney failure, but this, too, is extremely uncommon. The most common side effects from the contrast agent is a brief feeling of warmth when it is injected and a metallic taste in your mouth.

An angiogram is performed in the catheterization (cath) lab of a hospital. For the exam, you will lie on your back on an X-ray table. Safety straps may be fastened across your legs and chest to prevent you from moving if the table is tilted during the procedure, and blood pressure and heart rate monitors will be attached. You will have an IV line inserted and may be given a sedative to help you relax.

A catheter will be inserted at the appropriate site—for instance, into an artery in your groin or one in your arm—and carefully advanced to the area being examined. You should not feel any pain as the catheter is threaded through your blood vessels. Periodically, contrast material will be injected through the catheter, and you may notice a brief sensation of warmth or a metallic taste in your mouth.

Once the catheter is correctly placed, the doctor will inject more contrast material and take more X-ray images. This process may be repeated several times. Depending on what the doctor finds, you may have additional catheter procedures, such as balloon angioplasty or the placement of a stent.

Before your angiogram, your health care team will talk with you about your medical history, including allergies and any medications and supplements you take. They may also perform a physical exam and check your vital signs.

Once the angiogram is completed, the catheter will be removed. You’ll need to lie on your back in bed for six hours to avoid bleeding. Pressure may be applied to the insertion site during this time.

You may be able to go home the same day, or you may need to stay in the hospital overnight. It is helpful to drink plenty of fluids to flush the contrast material from your system.

Your healthcare team will tell you how long you should avoid heavy lifting and strenuous activity, and when you can return to your normal routine.