Obesity and Bariatric Surgery

Abdominal Angiogram

What is an abdominal angiogram?

An angiogram is an imaging test that uses X-rays to look at your blood vessels. It's done to check for conditions such as:

Weak, stretched, or enlarged part of a blood vessel (aneurysm)
Narrowing of a blood vessel (stenosis)
Blockages

An abdominal angiogram looks at the blood vessels in your belly (abdomen). It may be used to check blood flow to the organs of the abdomen, such as the bowel, kidneys, liver, and spleen. It may also be used to guide in the placement of medicine or other materials to treat cancer or bleeding in the abdomen.

Fluoroscopy is often used during an abdominal angiogram. This is a kind of X-ray movie, with X-rays showing the provider real-time images of the test.

Contrast dye is used so that the blood vessels appear solid on the X-ray image. This lets the radiologist see the blood vessels more clearly. Dye is injected into certain blood vessels to look at an area of blood flow more closely.

For an abdominal angiogram, the radiologist may put a small tube (catheter) into a large artery in your groin and then move it into a certain artery. Contrast is injected through this tube. Then the radiologist takes a series of X-ray pictures. These X-ray images show the blood flow in the abdomen. Or you could have a CT scan or MRI scan so your healthcare provider can see the arteries in your abdomen.

Why might I need an abdominal angiogram?

You may need an abdominal angiogram to find problems of the blood vessels in the abdomen. Problems include:

Aneurysms
Narrowing (stenosis) or spasms of the blood vessel (vasospasm)
A connection between the arteries and veins that isn't normal (arteriovenous malformation)
A blood clot within a blood vessel or blockage of a blood vessel

Other conditions that may be found include tumors and bleeding. Angiography may be used to direct medicine being inserted directly into tissue or an organ. This might include clotting medicine to the site of bleeding or cancer medicine into a tumor.

Your healthcare provider may have other reasons to advise an abdominal angiogram.

What are the risks of an abdominal angiogram?

You may want to ask your healthcare provider about the amount of radiation used during the test. Also ask about the risks as they apply to you.

Consider writing down all X-rays you get, including past scans and X-rays for other health reasons. Show this list to your provider. The risks of radiation exposure may be tied to the number of X-rays you have and the X-ray treatments you have over time.

Tell your healthcare provider if:

You are pregnant or think you could be. Radiation exposure during pregnancy may lead to birth defects.
You are allergic to or sensitive to medicines, contrast dyes, local anesthesia, iodine, or latex
You have a history of kidney disease
You are breastfeeding. Your provider will tell you how long to wait after your test to continue breastfeeding

Because the procedure involves the blood vessels and blood flow of the abdomen, there is a small risk for complications in the abdomen. These include:

Bleeding because of cut (puncture) of a blood vessel
Injury to nerves
Blood clot in the blood vessel
Area of swelling caused by a buildup of blood (hematoma)
Infection
Organ damage

There is an additional risk with the use of contrast agents. These risks include kidney damage and allergic reaction.

You may have other risks depending on your specific health condition. Talk with your provider about any concerns you have before the procedure.

How do I get ready for an abdominal angiogram?

Tips for being prepared:

Your healthcare provider will explain the procedure to you. Ask them any questions you have about the procedure.
You may be asked to sign a consent form that gives permission to do the procedure. Read the form carefully and ask questions if anything is not clear.
Tell your healthcare provider if you have ever had a reaction to any contrast dye, or if you are allergic to iodine.
Tell your healthcare provider if you are sensitive to or are allergic to any medicine, latex, tape, or anesthesia.
Follow any directions you are given for not eating or drinking before surgery.
Tell your healthcare provider if you are pregnant or think you could be.
Tell your healthcare provider of all prescription and over-the-counter medicines and herbal supplements that you are taking.
Tell your healthcare provider if you have a history of bleeding disorders. Also tell your provider if you are taking any anticoagulant (blood-thinning) medicines, aspirin, or other medicines that affect blood clotting. You may be told to stop these medicines before the procedure.
Your healthcare provider may order a blood test before the procedure to find out how long it takes your blood to clot. You may need other blood tests as well.
You may get medicine (sedative) to help you relax before the procedure if needed. You may also get an anticholinergic medicine. This slows down how much saliva you make. It also slows how much stomach acid you make and the activities of the intestinal tract. If you get this medicine, you may notice that your mouth feels dry.
Depending on the site used for injection of the contrast dye and your overall medical condition, the recovery period may last up to 12 to 24 hours. You may need to spend the night in the hospital.
Based on your condition, your healthcare provider may ask for other preparations.

What happens during an abdominal angiogram?

You may have an abdominal angiogram as an outpatient or as part of a hospital stay. The way the test is done may vary depending on your condition and your healthcare provider's practices.

Generally, an abdominal angiogram follows this process:

You will need to remove any clothing, jewelry, or other objects that may get in the way of the test.
You will be given a gown to wear.
You will be asked to empty your bladder before the start of the procedure.
You will be positioned on the X-ray table.
An IV (intravenous) line will be put in your arm or hand.
You will be connected to a heart monitor that records the electrical activity of the heart and monitors the heart during the procedure. The healthcare team will watch your heart rate, blood pressure, and breathing rate during the procedure.
The radiologist will check your pulses below the injection site for the contrast dye and mark them with a marker. This is so the blood flow to the limb below the site can be checked after the procedure.
The skin will be cleaned at the injection site in the groin. You will get a local pain killer. Sometimes an artery in the elbow area of the arm may be used.
Once the needle has been placed, a long, thin tube (catheter) will be placed into the artery at the groin or arm site. The radiologist will use fluoroscopy to check the location of the catheter within the abdomen.
The radiologist will inject the contrast dye. You may have a flushing sensation, a salty or metallic taste in the mouth, a brief headache, and nausea or vomiting from the contrast. These effects usually last for a few moments.
Tell the radiologist if you have any breathing trouble, sweating, numbness, or fluttering heartbeat (palpitations).
After the contrast dye is injected, the radiologist will take a series of X-rays. The first series of X-rays shows the arteries. The second series shows capillary and venous blood flow.
You may have more than 1 injection of contrast dye.
Once the procedure is done, the healthcare team will remove the catheter and put pressure over the area to keep the artery from bleeding.
After the site stops bleeding, a dressing will be applied to the site. A sandbag or other heavy item may be placed over the site for a time to keep it from bleeding more or from forming a blood clot (hematoma).

What happens after an abdominal angiogram?

After the procedure, you will be taken to the recovery room for observation. Healthcare staff will watch the blood flow and feeling in your leg where the injection catheter was put in. A nurse will check your vital signs and the injection site.

You will stay flat in bed in a recovery room for several hours after the procedure. The leg or arm on the side of the injection site will be kept straight for up to 12 hours.

You may be given pain medicine for pain or discomfort at the injection site.

You will be urged to drink water and other fluids to help flush the contrast dye from your body.

You may go back to your usual diet and activities after the procedure, unless your healthcare provider advises you otherwise.

After recovery, you may go back to your hospital room or discharged to your home. If this procedure was done as an outpatient, plan to have someone drive you home.

Once at home, check the injection site for bleeding. A small bruise is normal. So is an occasional drop of blood at the site.

Watch the leg or arm for changes in temperature or color, pain, numbness, tingling, or loss of function.

Drink plenty of fluids to prevent dehydration and to help pass the contrast dye.

You may be told to not do heavy activity and not to take a hot bath or shower for a period of time after the procedure.

Call your healthcare provider right away if any of these happen:

Fever or chills
Increased pain, redness, swelling, or bleeding or other drainage from the groin injection site
Coolness, numbness, tingling, or other changes in the affected arm or leg

Your healthcare provider may give you other instructions after the procedure, depending on your situation.