Peripheral Vascular Angiogram
What is it?
Peripheral artery disease (PAD) is a narrowing of arteries in other parts of the body—most commonly in the arteries of the legs. PAD is similar to coronary artery disease (CAD). Both PAD and CAD are caused by atherosclerosis, which narrows and blocks arteries.
Doctors use peripheral angiograms to evaluate blood flow in the arteries leading to your legs or, less frequently, to your arms. The procedure takes pictures of the arteries in your extremities and reveals any narrowed or blocked arteries.
The angiogram helps your doctor decide if a surgical procedure such as peripheral angioplasty is needed to open the blocked arteries. Bypass surgery, which reroutes blood around the blocked arteries, is another treatment option.
Atherosclerosis and PAD
Atherosclerosis is a disease in which plaque builds up on the wall of an artery. Plaque formation—a waxy buildup of cholesterol, cells, and other substances—can grow large enough to significantly reduce blood flow. When plaque becomes brittle or inflamed it may rupture. This can trigger the formation of a blood clot that further narrows the artery or blocks it entirely.
If the blockage remains in the peripheral arteries in the legs, it can cause pain, changes in skin color, sores or ulcers and difficulty walking. Total loss of circulation to the legs and feet can cause gangrene, which may require amputation.
The most common symptoms of PAD are cramping, pain, or tiredness in the legs or hips while walking or climbing stairs. Typically, this pain goes away with rest and returns when you walk again. Many people mistake the symptoms of PAD for something else. Left untreated, PAD can lead to gangrene and amputation.
Added risks for PAD
- Smokers have an especially high risk for PAD.
- Diabetics have an especially high risk for PAD.
- People with high blood pressure or high cholesterol are at risk for PAD.
- PAD increases your risk of heart attack or stroke.
- Your risk of developing PAD increases with age.
The good news for PAD patients
- PAD is easily diagnosed in a simple, painless way.
- Most cases of PAD can be managed with lifestyle changes and medication.
- You can take control by following the recommendations of your doctor.
Frequently Asked Questions
The angiogram helps you and your doctor decide if a surgical procedure such as peripheral angioplasty to open the blocked arteries. Bypass surgery, which reroutes blood around the blocked arteries, is another treatment option.
Serious risks and complications are very rare, but can include:
- Artery damage; emergency surgery may be needed to restore blood flow to the artery.
- Allergic reactions to the dye used in the test. Tell your doctor if you are allergic to dyes, iodine, or shellfish.
Your doctor will give you instructions about what you can eat or drink during the 24 hours before the test.
- Tell your doctor about any medicines you take—including over-the-counter drugs, supplements, herbs, and vitamins. He or she may ask you not to take them before your test. Don’t stop taking your medicines until your doctor tells you to.
- Tell your doctor or nurse if you are allergic to anything, especially iodine, shellfish, latex or rubber products, medicines like penicillin, or x-ray dye.
- Leave all of your jewelry at home.
- Before the test, a nurse will put an IV (intravenous line) into a vein in your arm so you can get medicine sedative to help you relax. You’ll be awake during the test.
- A nurse will clean and shave the area where the doctor will be working, usually in your groin.
- A local anesthetic will be given to numb the needle puncture site.
- The doctor will make a needle puncture through your skin, then insert a long, thin tube called a catheter into the artery. You may feel some pressure, but you shouldn’t feel any pain.
- The doctor will inject a small amount of dye into the catheter. This makes the narrowed or blocked sections of your arteries show up clearly on x-rays. The dye may cause you to feel flushed or hot for a few seconds.
- You will go to a recovery room for 6 to 8 hours.
- To prevent bleeding, the nurse will put pressure on the puncture site. After about 45 minutes, the nurse will remove the pressure and check for bleeding.
- The nurse will ask you not to move the leg used for the catheter.
- The nurse will continue to check for bleeding or swelling.
- Before you leave, the nurse will give you written instructions about what to do at home.
- Drink lots of liquids to make up for what you missed while you were preparing for the angiogram and to help flush the dye from your body. For most people, this means drinking at least 6 glasses of water, juice, or tea.
- You can start eating solid food and taking your regular medicines 4 to 6 hours after your angiogram.
- Don’t drive for at least 24 hours.
- The puncture site may be tender for several days, but you can probably return to your normal activities the next day.
A small bruise at the puncture site is common. If you start bleeding from the puncture site, lie flat and press firmly on that spot. Ask someone to call the doctor who did your peripheral angiogram.
- The puncture site swells up very fast.
- Bleeding from the puncture site does not slow down when you press on it firmly.
The most important steps you can take are:
- Quit smoking and avoid secondhand smoke.
- Be physically active. Walk, ride a bike, or do other types of moderate physical activity for at least 30 minutes five days a week.
- Know your blood pressure numbers. Work with your doctor to reach a blood pressure of less than 120/80.
- Lower your cholesterol levels. Eat foods high in fiber and low in saturated and trans fats) and take your cholesterol-lowering medicine.
- If you have diabetes, work with your doctor to keep your blood sugar under control and reach and maintain an HbA1c of less than 7%.
- If you are overweight, set your initial goal at a loss of 5 to 10 pounds. If you need to lose more, a weight loss of 1 to 2 pounds per week is recommended until you reach a healthy weight.
- If you drink alcohol, have only one drink a day if you’re a woman, no more than two if you’re a man.