Patient care

Before the procedure: health care professionals explain to the patient how a needle or catheter will be used to penetrate a blood vessel, and that a contrast agent will be injected into it to highlight the course of the vessel (map the vessel) and any abnormalities in it or associated with it. These abnormalities may include widenings and weaknesses in the blood vessels (aneurysms); narrowings of the vessel (stenoses or obstructions); abnormal connections between arteries and veins (fistulae); or unusual networks of vessels (arteriovenous malformations or in some cases, the complex blood supply of malignant tumors). Complications of angiography include damage to the blood vessel or neighboring tissues, bleeding or bruising, cardiac arrhythmias, syncope, infection, or, in very rare instances, death. These potential complications should be fully reviewed with the patient during the informed consent that precedes the procedure.

During the procedure: the patient’s heart rate and rhythm are closely monitored, along with his or her blood pressure, oxygenation, mental status, and in critically ill patients, urinary output. The patient may experience a hot flush during the injection of contrast, palpitations, or other unusual sensations. These sensations should be explained to the patient before they occur to minimize anxiety. Anxiolytics or sedatives may sometimes be administered to patients as needed.

After the procedure: the puncture site is tamponaded and bandaged and then monitored for signs of bleeding or bruising. The part of the body distal to the puncture site is periodically assessed for pulse, color, warmth, sensation, and movement. The patient is permitted to mobilize only after the puncture site is stabilized and institutional protocols are completed.