Angiography and Intervention
What is an Angiogram?
An angiogram is a picture of an artery that is used to evaluate areas with decreased or no blood flow. To perform the angiogram, a physician injects a small amount of local anesthetic around the femoral artery in the groin. Then the physician inserts a very small needle and injects a liquid, or contrast, to make the vessel visible. Highly specialized x-ray equipment takes pictures and records any obstruction or narrowing of the arteries. A wire and a catheter is then used to reopen the blocked arteries and restore blood flow to the legs. Once the wire and catheter have traversed then we can open the vessel using a variety of techniques:
Angioplasty occurs when a balloon is temporarily inflated in the blocked portion of the artery to open the area of narrowing. This balloon is expanded to widen the opening of the artery (lumen). This can restore blood flow through a once obstructed region. Occasionally this will be all that is needed to open the area of obstruction. At the end of the procedure, the balloon is deflated and removed.
When it is necessary we will place a stent. A stent is a special tube shaped metal scaffold that can be used hold open the area that was obstructed. The stent is left in the artery and is permanent.
Atherectomy: These devices are designed to actually remove the material that is blocking the artery. This is different from angioplasty or a stent procedure in which the material that is blocking the vessel is not removed, it remains in the artery and is pushed aside. There are a number of atherectomy devices and at San Francisco Vein and Vascular Institute, and we have access to the latest and most effective of these technologies. There is a laser device that vaporizes the blockage, an orbital sanding device that shaves down the blockage, and a special suction drill that simultaneously routes and suctions the material blocking the artery. We tailor the device to the needs of the patient. The characteristics of the material blocking the artery as well as the location and extent of the blockage will dictate the type of device utilized.
Drug eluting technologies: In the last few years, new drug eluting balloons and stents have been approved by the FDA. In some instances these devices have been shown to decrease the rate of recurrent blockage after treatment.
After the procedure, you will lie flat for a period of 1 to 3 hours without bending your leg. You will be able to go home that same day. You will not be able to drive home, or take a cab alone. You will be given more detailed information at the day of your angiogram.