Coronary Angiography (Angiogram)

A patient having a coronary angiogram under local anaesthesia

An angiogram is a test which allows the Doctor to visualise the coronary arteries. The procedure is normally performed as a day case. You will need to fast overnight for your procedure first thing in the morning. You will be admitted to hospital. The nurses will take some details from you, check for any potential issues such as previous allergic reactions, drugs in the past, check the medication you are taking. You will be asked to sign a consent form. This will be an opportunity for the doctor to explain the procedure to you and for you to ask any questions. When you have signed the consent form, you will be taken down to the cardiac catheterisation laboratory.

The procedure can be done from the wrist (the radial artery) or the leg (the femoral artery). In the Catheterisation Laboratory, the doctor will place a local anaesthetic at the puncture site. When the artery is completely frozen and anaesthetised, the doctor will insert a tiny plastic tube into the artery. Through this tiny plastic gateway, he will conduct the procedure.

Specially shaped plastic pipes allow the mouth of the coronary arteries to be engaged. A special radio-opaque dye is injected through the tube and x-ray pictures are taken. This allows the doctor and his team to see any narrowings or blockages. The whole procedure takes about 10 minutes.

Plastic pipes used for coronary angiography

When the doctor has gathered all the data that is required, the tube will be removed from the leg. More often than not, a special sealing device will be placed at the top of the leg, in the form of a tiny metal clip, which seals off the puncture site of the artery and prevents any further bleeding. You will be able to sit up and have a drink almost immediately and mobilise within 2 hours. Thereafter, someone may escort you home later that day.

What are the risks from coronary angiography?

This is a very safe test. On rare occasions there can be complications such as:

• A heart attack, stroke or death (risks are less than 1 in 1000). The risk may be increased if you are having angina or a heart attack at the time, or if you have diabetes.
• Rarely. The catheter can damage the artery, in which case you may have to stay in hospital and have it repaired. (Risks are 1 in 500).
• Bleeding or bruising especially around the area where the catheter was inserted. This can be made worse if you are on any anti-clotting drugs.
• Allergic reaction to the dye. (Risk 1 in 100). This is usually very mild and temporary, such as skin rash.