Why do I need a Femoral Angiogram?
A femoral angiogram is helpful is identifying the site and extent of narrowing or blockage in the arteries in one or both legs. The angiogram will provide us with a detailed map of the blood vessels in your legs to see if any treatment can be offered to relieve your symptoms.
Preparation
Sometimes the contrast (“dye”) injection can make people feel sick and you will need to fast (no food or drink) for at least six hours before the procedure and usually from midnight the night before.
Your doctor will arrange to stop any medications that could interact with the contrast used during the procedure (e.g. glucophage). Medications that increase the risk of bleeding – such as Warfarin or Plavix - may also be stopped.
Procedure
The procedure is performed in the Xray department or the operating theatre and you will be brought there on a hospital trolley. Regardless of which leg is affected, either leg may be used for the procedure. Occasionally, an artery in the arm may be used.
The area chosen will be ‘frozen’ using an injection of local anaesthetic. Sometimes a a sedative injection will be given if this is safe, but this is not always necessary.
A needle is inserted into the artery, a wire passed through it and this is used to guide a tube (catheter) into the place that will allow us to take the best pictures of your blood vessels.
During the procedure, x-ray contrast is injected into the catheter and you may get a warm feeling in you legs and feet. You may also get the urge to pass water. This is normal and it is important to stay still during the injection. Feel free to tell the surgeon/radiologist if you are worried or uncomfortable. The procedure takes approximately 30mins.
When the catheter is removed, a doctor will press on the groin for up to 20mins to prevent bleeding. You will be brought back to the ward on a trolley and asked to lie in bed for up to six hours after the procedure to prevent bleeding. Your regular medication (where it has been withheld) will be restarted when it is safe to do so.
Are there any risks with the procedure?
Bruising and a little soreness are common after the procedure.
More serious complications occur in less than 1% and include:
- Significant bleeding may occur rarely and if this should happen, you may require an emergency operation. Occasionally, the little hole may fail to seal closed (pseudoaneurysm) and further treatment or an operation may be required. Rarely the site may also become infected.
- The contrast used in the procedure can sometimes cause an allergic reaction. This is severe in approximately one in 3,000. The contrast can also interfere with kidney function, especially in diabetics or if kidney function is already reduced.
- If an artery in the arm is used, the tube will pass one or more of the arteries supplying the brain. There is a very small risk that a blood clot could form and cause a stroke.
- The procedure can also put additional stress on the heart and rarely patients can suffer a heart attack during or after an angiogram.
- It is also possible, but rare, that the artery in the leg may block off, particularly if it is very narrow, and that the circulation to your leg could be impaired. Surgery may be necessary to correct this. In severe cases, the leg may be in danger
Recovery
After six hours (or sooner if your doctor or nurse tells you) you may sit up and start moving around. The groin may be a little sore afterwards but if you have any concerns, notice any swelling, severe pain, or have any new pain or numbness in your leg, please draw this to the attention of your doctor or nurse.
Prepared by Dr. John Keane, Tallaght Hospital, January 2007
