pheripheral angiography : what to expect

Peripheral angiography is very similar to cardiac catheterization.  It is performed in the cardiac catheterization lab in the hospital.  Because the procedures are so similar, please refer to the section on cardiac catheterization for further information. That being said, there are important differences between the peripheral angiogram and a cardiac catheterization. The most important difference is that peripheral angiography focuses on assessing the patency and integrity of blood vessels in the lower extremities compared to blood vessels that supply blood to the heart (coronary arteries).

 From the patient standpoint, the experience is very similar. The same precautions one would take during cardiac catheterization are also undertaken during peripheral angiography. In fact,  the place where the physician will enter the blood vessels of the leg, is exactly the same as they would when cardiac catheterization is performed. There are two main differences in the way  Dr. Rasi will be performing the  peripheral angiogram.

1.  The first difference, is that the site where the needle entry into the femoral artery happens, in the opposite leg usually, from where the blockage is suspected. This can be a confusing point for many patients. For example, if there is a nonhealing ulcer in your right leg, Dr. Rasi will place the catheter into the left leg. This discrepancy is because usually the best way to get to the left leg is from what cardiologists generally called the " up and over"  approach. 
2.  the second difference is that the catheters never travel up the aorta into the heart. The almost always travel down the opposite leg, or down the same leg.

 The main objective in a peripheral angiogram is to place the catheter tip at the beginning of the artery that supplies blood to your leg, and injure contrast to visualize whether or not the arteries of the legs are open. If there is a blockage, depending on whether or not it is correctable, Dr. Rasi may offer one of three options.

1.  the first option is to correct the blockage  with the use of a balloon angioplasty device, or rarely via stent placement.  This is typically the most straightforward approach.  If there is a problem accessing the vessel,  or if the blockage looks like it's more serious  Dr. Rasi may utilize a specialized device called an atherectomy device.  This  specialize device acts like the combination  of  sanding machine, along with a diamond coated drill bit. It is designed to be able to  bore through hard calcium in the peripheral arteries and facilitate the expansion of a balloon.
2.  Sometimes,  if the blockages in the leg are too difficult to fix, Dr. Rasi may refer you to a vascular surgeon  to undergo femoral bypass surgery. 
3.  Finally,  there may be rare options  where the only available therapy is medical therapy. This means you will be given medications in the hopes of mitigating the symptoms where no feasible mechanism exists to fix the lesion. 

 At the end of the powerful angiogram procedure, the recovery process is very similar to a cardiac catheterization.  You will be taken to the recovery area,  the sheath in your groin will be removed with the placement of a specialized closing device, or Dr. Rasi may elect to have the sheath manually removed and have someone hold pressure at that location until the vessel. You will usually spend a few hours in the recovery area and in 90% of the cases the patient go home the very same day whether or not an intervention was performed.  After every case, Dr. Rasi will discuss with you and your family the results of the procedure, and what exactly he performed.