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Abdominal Angiogram with Runoff


   1. Purpose of Test

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Abdominal aortograms with runoff are arteriograms of the lower abdominal aorta and arteries in the legs. This exam is often done when the patient has pain in the calf muscle after walking a short distance. Discoloration of the toes or feet or a "cold" foot are also symptoms that may warrant this study being done.


   2. What to expect during procedure

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An abdominal angiogram may be performed on an outpatient basis or as part of your stay in a hospital. Procedures may vary depending on your condition and your physician's practices.

Generally, an abdominal angiogram follows this process:
You will be asked to remove any clothing, jewelry, or other objects that may interfere with the procedure. You will be given a gown to wear. You will be asked to empty your bladder prior to the start of the procedure. You will be positioned on the x-ray table. An intravenous (IV) line will be inserted in your arm or hand. You may be connected to an EKG monitor that records the electrical activity of the heart and monitors the heart during the procedure using small, adhesive electrodes. Your vital signs (heart rate, blood pressure, and breathing rate) will be monitored during the procedure. The radiologist will check your pulses below the injection site for the contrast dye and mark them with a marker so that the circulation to the limb below the site can be checked after the procedure. An intravenous line will be inserted into an artery in your groin after the skin is cleansed and a local anesthetic is injected. On occasion, an artery in the elbow area of the arm may be used. If the groin or arm site is used, the site will be shaved prior to insertion of the IV. If the arm site is used, a blood pressure cuff will be applied to the arm below the IV site and inflated to prevent flow of the contrast dye into the lower arm. Once the IV needle has been placed, a catheter (a long, thin tube) will be inserted into the artery at the groin or arm site. Fluoroscopy may be used to verify the location of the catheter within the abdomen. An injection of contrast dye will be given. You may feel some effects when the dye is injected into the IV line. These effects include a flushing sensation, a salty or metallic taste in the mouth, a brief headache, or nausea and/or vomiting. These effects usually last for a few moments. You should notify the radiologist if you feel any breathing difficulties, sweating, numbness, or heart palpitations. After the contrast dye is injected, a series of x-rays will be taken. The first series of x-rays shows the arteries, and the second series shows capillary and venous blood flow. Depending on the specific study being performed, there may be one or more additional injections of contrast dye. Once sufficient information has been obtained, the IV catheter will be removed and pressure will be applied over the area to keep the artery from bleeding. After the IV 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 period of time to prevent further bleeding or the formation of a hematoma at the site.

After the procedure, you will be taken to the recovery room for observation. The circulation and sensation of the leg where the injection catheter was inserted will be monitored. A nurse will monitor your vital signs and the injection site.
You will remain flat in bed in a recovery room for several hours after the procedure. If the groin or arm site was used, 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 medication for pain or discomfort related to the injection site or to having to lie flat and still for a prolonged period.

You will be encouraged to drink water and other fluids to help flush the contrast dye from your body.
You may resume your usual diet and activities after the procedure, unless your physician advises you differently.
When you have completed the recovery period, you may be returned to your hospital room or discharged to your home. If this procedure was performed as an outpatient, you should plan to have another person drive you home.





   3. How to prepare for test

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Your physician will explain the procedure to you and offer you the opportunity to ask any questions that you might have about the procedure. You will be asked to sign a consent form that gives permission to do the procedure. Read the form carefully and ask questions if something is not clear.

Notify your physician if you have ever had a reaction to any contrast dye, or if you are allergic to iodine or seafood. Notify your physician if you are sensitive to or are allergic to any medications, latex, tape, and anesthetic agents (local and general). You will need to fast for a certain period of time before the procedure. Your physician will notify you how long to fast, whether for a few hours or overnight. Notify your physician if you are pregnant or suspect you may be pregnant.
Notify your physician of all medications (prescribed and over-the-counter) and herbal supplements that you are taking. Notify your physician if you have a history of bleeding disorders or if you are taking any anticoagulant (blood-thinning) medications, aspirin, or other medications that affect blood clotting. It may be necessary for you to stop these medications prior to the procedure. Your physician may request a blood test prior to the procedure to determine how long it takes your blood to clot. Other blood tests may be done as well. You may receive a sedative prior to the procedure if necessary. You may also receive an anticholinergic medication, which acts to slow down the production of saliva in the mouth, inhibit the production of acid in the stomach, and slow down the activities of the intestinal tract, among other effects. If you receive this medication, you may notice that your mouth feels dry. Depending on the site used for injection of the contrast dye, the recovery period may last up to 12 to 24 hours. You should be prepared to spend the night if necessary. Based upon your medical condition, your physician may request other specific preparation.





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