Patients who have circulation problems in the aorta or leg arteries typically undergo at least one non-invasive study of the circulation. These tests may involve ultrasound, CT angiography or MR angiography. Symptoms such as leg pain with exertion, non-healing ulcers or rest pain are often due to a significant circulation problem such as a blocked or narrowed artery, or in some cases an aneurysm. Ultimately, a patient with peripheral vascular disease (“PVD”, sometimes called peripheral arterial disease or “PAD”) will be brought to the catheterization lab for invasive angiography which allows for confirmation of the non-invasive study findings as well as allowing, in many cases, for peripheral vascular intervention to “fix” the problem. (See Peripheral Vascular Intervention for more information).
What to Expect for Peripheral Angiography
A peripheral angiogram is performed similarly to cardiac catheterization. The patient receives intravenous sedation as well as a local anesthetic in the groin area before an introducer sheath (about the diameter of a straw) is inserted into the femoral artery. Contrast (“dye”) can be injected through the sheath and pictures are taken of the leg arteries down to the foot. A diagnostic catheter is advanced through the introducer sheath to the abdominal aorta. Contrast is injected and x-ray pictures (“angiograms”) are obtained of the abdominal aorta. The catheter is then advanced under x-ray to the opposite groin artery. Contrast is injected down the leg and angiograms of that leg’s arteries are obtained. Once the angiography is completed, intervention may be performed, or the catheter and introducer sheath can be removed completing the procedure.
Risks of the Procedure
The risks of a diagnostic peripheral angiogram are very low, typically <1%. Possible complications include bleeding from the access site, allergic reactions to the contrast, kidney problems related to the contrast, inadvertent damage to a blood vessel.