Appointments – Freeman Hospital: (0191) 223 1012 RVI: (0191) 282 5627
What is angioplasty?
An angioplasty is a way of re-opening a blocked artery by inserting a fine plastic tube, called a catheter, through the blockage and inflating a small balloon on the catheter.
What is a stent?
A stent is a small tube, made of a metal mesh framework, which expands in a blocked artery and may help to keep the artery open. It is introduced on a catheter like that used for angioplasty and by the same sort of procedure.
Why do I need an angioplasty or stent?
Your doctors have detected a problem in part of your circulation. You may already have had an angiogram or ultrasound to show the blockage. Whilst surgical treatment is needed in some cases, in your case it is likely that angioplasty or a stent will either relieve your symptoms completely or delay the need for surgery.
Who has made this decision?
The doctors looking after you will have discussed the possible treatment options with the Interventional Radiologist (the X-ray doctor) responsible for performing your angioplasty. You will also be given the opportunity to discuss the various types of treatment because your informed consent has to be given prior to treatment. If you do not want to undergo this treatment, then the procedure will be taken no further.
Who performs the angioplasty?
Your procedure will be performed by an Interventional Radiologist (medical doctor who specialises image guided procedures). The Radiologist will explain what happens and will show you what to do.
What preparation will I need?
Printed instructions will be given to you with your appointment details. Your doctors may start you on a small dose of Aspirin (or an equivalent drug) at least two days prior to the angioplasty. You may eat a light meal at least 2 hours prior to the procedure and fluid intake should not be restricted.
On admission to the Ward your blood pressure and pulses will be checked and you will be asked to put on a hospital gown.
As the angioplasty is usually done through the artery in the groin (the femoral artery) you may be asked to shave this area.
It is very important that you inform the nursing and medical staff about all allergies. If you have had reactions to intravenous contrast medium, the dye used for kidney X-rays (IVPs) and for CT scanning, then you must also tell your doctor about this
What happens during the angioplasty and how is it performed?
After the admission procedures on the ward, a nurse will accompany you to the X-Ray Department.
The radiology nurse will discuss basic details of the procedure with you and the interventional radiologist will answer any further questions you may have.
You will be transferred onto the X-ray table, generally flat on your back.
The radiologist may place a small needle in a vein in your arm, if sedation is required.
We will monitor your blood pressure, heart rate and pulse.
After the radiologist has checked the pulses in your groin, the nurse will clean the skin in this area with antiseptic fluid and cover the rest of your body with a drape.
Local anaesthetic will be injected into the tissues around the artery and when the skin in this area is completely ‘numb’, a needle will be inserted into the artery through a tiny nick in the skin.
A guide wire is passed through this needle and the needle is then removed.
The catheter can then be threaded over the wire into the artery and guided into the blocked segment of artery using the X-ray images as a ‘road map’.
The small balloon on the catheter is then inflated when it has reached the middle of the narrowing.
Local Anaesthetic
Your radiologist will ask you to keep quite still while the injections are given. You may notice a warm tingling feeling as the anaesthetic begins to take effect.
Your procedure will only go ahead when you and your radiologist are sure that the area is numb.
If you are not having sedation, you will remain alert and aware of your surroundings.
Your radiologist is always near to you and you can speak to him/her whenever you want to.
How does it feel?
You may get a ‘tight’ sensation during balloon inflation, but it’s not usually painful. When the catheter is removed a small hole is left in the artery. Therefore one of the radiology team will have to press on the puncture site firmly for 5 – 10 minutes and this can be uncomfortable.
How long will the angioplasty take?
This varies according to the complexity of the blockage in your artery but expect to spend anything from 45 minutes to 2 hours in X-ray.
What happens afterwards?
You will be taken back to the ward on a trolley.
Nurses on the ward will carry out routine observations, such as taking your pulse and blood pressure. They will also check for bleeding or swelling in the groin.
You will generally stay in bed for 4-6 hours. You may be allowed home on the same day, or kept in hospital overnight depending on your progress.
What are the benefits of having an angioplasty?
Angioplasty is an effective way of improving symptoms caused by narrowed or blocked arteries, often avoiding the need for more major operations.
What are the risks of having an angioplasty?
The commonest complication is the development of a deep bruise, called a haematoma, at the puncture site. In about 4% of cases this may require treatment with a blood transfusion or (very rarely) a small operation to stitch the hole in the artery.
In about 1% of angioplasties, either the treated section of artery or the smaller blood vessel just beyond this area becomes completely blocked with debris loosened by the balloon. This complication may lead to an emergency operation to remove the blockage. Overall, less than 3% of angioplasty or stent procedures will result in an urgent surgical operation to fix a bleeding puncture site or re-open a blocked artery.
If I am Diabetic, does this change anything?
Yes. The preparation procedure may change. If you are diabetic and take insulin, you may need a drip to keep your blood sugars controlled. This will be discussed with you on the ward prior to the procedure. Please ring our helpline number (see next question).
I take Metformin (Glucophage, Avandamet) Tablets. Does this change anything?
Yes – Metformin (Glucophage, Avandamet) is most commonly taken by diabetic patients to control blood sugar, but occasionally is taken for other conditions. If you are taking Metformin, your preparation for the procedure may change. Please ring the helpline telephone number, as below, and ask to speak to a member of staff who will be able to advise you:
| Freeman Hospital | 0191 2231012 |
| RVI | 0191 2825627 |
When will I get the results?
The results will be sent to the consultant who asked for it to be done within two weeks of your examination. On receipt of this result your referring consultant will invite you back to clinic to discuss the results.
Can I drive home?
No we advise that you do not drive home after angioplasty. You should arrange alternative transport
I need an ambulance/transport. Do you arrange it?
If you need an ambulance/ transport, you should ask your GP Surgery for details of how to arrange it. You will need to give them at least three working days notice. Please note that hospital transport is provided on medical need only.
What if I cannot attend for my appointment?
If your appointment time is not convenient please contact the hospital department immediately so that a more appropriate time can be arranged. This will enable us to reallocate valuable scanning time to someone else.
| Freeman Hospital | 0191 2231012 (8.30am-5.00pm) |
| RVI | 0191 2825627 (8.30am-5.00pm) |
Diagnostic Imaging Dataset
Information from your diagnostic test will contribute to the Diagnostic Imaging Dataset.
The Diagnostic Imaging Dataset (DID) is a database that holds information on the imaging tests and scans carried out on NHS patients. This will allow the Health and Social Care Information Centre to see how different tests are used across the country.
Nothing will ever be reported that identifies you. All information is stored securely. It is only made available to appropriate staff, and is kept strictly confidential. However, if you do not want your information to be stored in the DID, please tell the people who are treating you. They will make sure your information is not copied into the DID.
You may, at a later date, still decide to opt out. Please contact the Health and Social Care Information Centre directly, their contact details are:
Telephone: 0845 300 6016
Email: [email protected]
Website: www.ic.nhs.uk
What if I have any comments, suggestions or complaints?
Should you have any suggestions or concerns, please make these known to the person conducting your examination or by letter addressed to the hospital that you are attending your examination:
The Departmental Manager
X-ray Department Level 3, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, NE1 4LP
Telephone: (0191) 282 1099
Or:
The Departmental Manager
Main X-ray Department, Freeman Hospital, High Heaton, Newcastle upon Tyne, NE7 7DN
Telephone: (0191) 282 1099
Monday to Friday 8.30am to 5.00pm
Switchboard: (0191) 233 6161 (24 hours)
The Patient Advice and Liaison Service (PALS) can offer on-the-spot advice and information about the NHS. You can contact them on freephone 0800 032 02 02 or email [email protected]
Information produced by: Dr C Nice, Consultant Radiologist
