Need to Know
Nice to Know
Why is This Exam Done?
Arthrograms can be diagnostic or therapeutic. Therapeutic arthrograms often distend the joint with cortisone and lidocaine, with a common site being the shoulder. Diagnostic arthrograms can be helpful in determining the cause of pain using CT or MRI guidance.
How Does It Work?
Your physician will insert a small catheter (a long, thin tube) into your groin and inject contrast material (also called dye). Then, using fluoroscopy, a form of X-rays that can see movement in real time, your doctor will evaluate the blood flow in your kidneys.
What Happens — Before, During, and After?
When you arrive for your procedure a nurse will greet you and let the team know you’ve arrived. You will be brought into an exam room and asked to change into a gown. Your doctor will greet you, explain the procedure and answer any questions you may have.
You will be asked to empty your bladder before the procedure begins. You will lie on an exam table for the procedure. The technologist or nurse will help you get as comfortable as possible as you will need to lie very still during the procedure. The nurse or technologist will connect monitors for your heart rate, blood pressure, and pulse, and an intravenous (IV) line will be inserted into a vein in your hand or arm. This will be used to give you sedatives during the procedure.
The technologist will shave, sterilize, and cover the area around your groin with a surgical drape. The area around your groin will then be numbed using a local anesthetic. You may feel a tiny pinch when the anesthesia is administered.
Guided by fluoroscopy imaging, your doctor will make a tiny incision in your skin and insert a catheter into your arteries. You may feel some pressure as the catheter is inserted but no real pain. Once the catheter is in place, your doctor will inject contrast material that will make your blood vessels visible on the X-rays. You may feel a warm sensation as the contrast material is injected.
With the assistance of the fluoroscopic images, your doctor will then evaluate the flow of blood in your kidneys and diagnose any blockages or other problems. In some cases an interventional procedure such as a stent placement can be done simultaneously. If an intervention is needed, more images will be taken to re-evaluate the blood flow. This exam can take anywhere from an hour to several hours to complete.
Once the exam is finished, the catheter will be removed and pressure will be applied for several minutes to the wound to stop any bleeding. You will not require stitches. Your intravenous line will be removed and you will be taken to a recovery area to rest for several hours. When you feel ready you will be able to go home. You will need someone to drive you home if you have been sedated.
Your doctor will discuss any results with you and talk to you about any follow-up appointments you may need.
How Should I Prepare?
There are things you can do to make your experience more comfortable, and many of these will depend on your individual preferences. You might like to keep a list of questions or — as you’re doing now — educate yourself about the procedure.
Some other things to keep in mind in planning for this procedure include:
- You will need to arrange to have someone drive you home after the procedure
- Your doctor may ask you to stop taking aspirin, non-steroidal anti-inflammatory drugs (NSAIDS), or blood thinners (such as Coumadin or warfarin) for a time before the procedure
- The day before the procedure (or the Friday before, if you’re scheduled for a Monday procedure), a nurse from your doctor’s office will call you. The nurse will give you any additional instructions, and will ask if you have any questions.
- When you arrive, make sure the nurse or doctor knows about any allergies you may have, especially allergies to contrast dye and to local anesthetics, such as lidocaine. If there’s any chance you may be pregnant, tell your physician.
What Should I Bring?
On the day of your procedure you should:
- Avoid bringing valuables or jewelry
- Wear loose, comfortable clothing
- Wear comfortable shoes
What Are the Benefits and Risks?
The benefits of an angiogram could be:
- Accurate, detailed diagnosis of kidney disease – including blockages or vessel damage. Better diagnosis may lead to better treatment options.
- In some cases, if there is a narrowing of an artery, treatment can be done during the angiography such as stent placement. This eliminates the need for additional procedures.
- X-rays have little to no side-effects when used for diagnosis and no radiation remains in your body after the procedure
Some risks you should be aware of include:
- As with any procedure there is a slight risk of infection. This is rare.
- Risk of allergic reaction to the contrast dye used during the procedure
- X-rays pose a slight risk of cancer from radiation
- Slight risk of blood clotting around the catheter causing a blockage and requiring surgery
- If you have kidney disease or diabetes you should be aware of the risk of kidney damage from contrast material. Please talk to your doctor about this risk.
- There is a slight risk of a drop in blood pressure if blood flow is suddenly restored to your kidneys
- Very rarely, the artery may be punctured by the catheter and cause bleeding
Keep in mind that this information is general. Your radiologist is the best source of information about how these risks and benefits may apply to you.