Angiogram
Consent: *** Arteriogram (abdominal, hepatic, thoracic, extremity, etc) with possible
intervention to include *** (as appropriate)
Risks of the procedure:
Bleeding, infection, vessel or organ injury, embolism, hematoma, allergic reaction, tissue
ischemia
H&P: Yes, if not done within 30 days. If done within last 30 days can do an addendum
with Airway evaluation
Pre-procedure orders:
Nursing:
VS
Cardiac monitor
Pulse ox – continuous
IP Nursing to place and maintain PIV
Diet NPO except medications
If patient is diabetic follow diabetic guidelines
Hold SQ Lovenox/Heparin 8 hours prior to IR
If patient has obstructive sleep apnea send CPAP with pt to room
Procedural sedation: IV Versed, IV fentanyl
If heparin allergy notify control room to only use straight saline
Labs:
POC glucose pre and post procedure if diabetic
Urine preg if child bearing aged female
PT/INR if on anticoagulation if indicated
Other labs as may be indicated (platelets)
IVF: 0.9NS at 50mL/hr or as indicated for renal function/chf/etc
Antibiotic prophylaxis: NONE – consider Ancef 2G if accessing through graft
Procedural sedation: Versed and Fentanyl IV
Local anesthetic: Lidocaine 1% SQ, Sodium Bicarbonate 1mEq
Contrast: Omnipaque 150mL IA for torso and upper body, Visipaque for lower
extremities (100-150mL)
See contrast allergy management under tips and tricks
Intraprocedure orders: None
Post procedure orders:
Nursing:
VS and Neurovascular checks and check puncture site of the affected extremity Q
15 mins x 2, Q 30 minutes x 2, every hour x 2, and then every shift until DC
and/or prn
Monitor puncture site for bleeding
Apply pressure prn
Keep affected extremity straight and immobile for 2 hours post procedure if
angioseal device was used, for 6 hours post procedure if angioseal device was
NOT used.
Keep supine, may log roll; however, leg must remain straight
Ambulate 1 hour prior to DC and reevaluate puncture site
POC glucose if diabetic
RN to educate on angiogram discharge instructions
Procedure note: IR MD post procedure note template
Discharge/disposition: Home after prescribed bed rest/leg restrictions plus 1 hour
procedure if stable and comfortable
Med rec with no new Rx and resume home meds and add d/c time and disposition
Discharge instructions: IR DISCHARGE ANGIOGRAM
If on Metformin hold for 72 hours
Home meds: May resume home medications. If on blood thinners may resume that night
or next day
Discharge Instructions
You had a procedure called spine biopsy . The instructions below are to help you care
for your back when you are at home.
After sedation instructions:
 Do not drive a car or operate machines for 24 hours after the procedure.
 Do not make important decisions or sign legal documents for 24 hours after the
procedure.
 Do not drink alcohol for 24 hours after the procedure or while taking pain
medicines.
 Go home and rest quietly for the rest of the day.
Medications:
 You may start taking all of your usual medicines when you are sent home from
the hospital.
 Do not take blood thinners (example: Coumadin, Plavix, Lovenox, etc…),
NSAIDS (ibuprofen), or Aspirin for 24 hours after the procedure unless your
doctor tells you that you can.
 Continue to take pain medicines as ordered for 72 hours after the procedure.
Your doctor will help you to slowly stop taking your pain medicines as you start
feeling better.
 Try to take pain medicines with food because they may cause an upset stomach.



You may take Tylenol (acetaminophen) every 4-6 hours or Motrin (ibuprofen)
every 6 hours as needed.
If you take Motrin, take it with food to help avoid stomach ulcers from forming.
If you are taking pain medicines, take a stool softener and laxative to avoid
constipation.
Diet:
 You can eat your usual diet. Drink plenty of fluids. This means 6 to 8 glasses of
fluids each day.
Activity:
 No heavy lifting (no more than 10 pounds, a gallon of milk weighs about 9
pounds) or using a pushing or pulling motion for 5 days after the procedure.
 The day of the procedure relax. Too much activity may increase your discomfort.
 Slowly increase your activity as you are feeling able to.
 Avoid straining. You may sit up and walk stairs.
 You may remove the dressing from your back and shower the day after the
procedure.
 Do not take a bath, sit in a hot tub, or swim for 3 days after the procedure.
 You may use ice packs, as needed, to help with pain. Place the ice packs at the
site in 20 minute intervals (20 minutes on, 20 minutes off). Always protect your
skin-do not place ice directly onto your skin.
Call right away if you notice any of the following:
 Bad back pain or back pain that is getting worse
 Increased redness, swelling, drainage, or warmth around the incision sites
 Fever more than 101 degrees or shaking and chills for 1 week after the
procedure
 Weakness, numbness, or tingling that starts in your legs
 Bad headache
 Pain that does not get better with the ordered medicines
 Call 911 if you have shortness of breath or chest pain
If these symptoms occur or if you have any other questions or concerns, call the
Interventional Radiology Clinic at 414-805-9112 Monday thru Friday 8:00 a.m. to
4:30 p.m. Overnight, weekends, or holidays call the hospital at 414-805-6700 and
ask for the Radiology Resident on call to be paged.
Post Angiogram Care Discharge Instructions
You have had an angiogram to study the blood vessels in your body and the blood flow
by using a special solution that shows up on x-ray. The information below will help you
to take care of yourself at home during the recovery.
After sedation instructions:
 Do not drive a car or operate machines for 24 hours after the test
 Do not make important decisions or sign legal documents for 24 hours after the
test.
 Do not drink alcohol for 24 hours after the test or while taking pain medicines.
 Go home and rest quietly for the rest of the day.
Medications:
 You may start taking all of your usual medicines when you are sent home from
the hospital.
 Do not take blood thinners (example: Coumadin, Plavix, Lovenox, Aspirin,
Aleve, or Ibuprofen) for 24 hours after the test unless your doctor tells you
that you can.
 {if the patient is diabetic, enter dot "IRMETFORMIN" or delete
 You may use Tylenol (acetaminophen) for mild discomfort at the puncture site
every 4-6 hours.
.
Diet:
 Restart your usual diet
Activity:
 No heavy lifting (up to 10 pounds, a gallon of milk weighs about 9 pounds) or
using pushing or pulling motion for 3 days after the test.
 Do not bend at the waist for 3 days after the test
 Increase your activity slowly; take it easy when using stairs.
 You may take a shower the day after the test, and remove the dressing at your
groin site if it hasn’t already been removed.
 Do not soak in bath, sit in a hot tub, or swim for 5 days after the test.
Call right away if you notice any of the following:
 Bleeding from the puncture site, lie flat and apply direct pressure over the site for
15 minutes. If the bleeding persists, reapply pressure. Call 911 and have the
ambulance take you to the nearest emergency department.
 Fever more than 101 degrees
 Severe nausea and or vomiting
 You may develop bruising or mild discomfort at the puncture site. This should
resolve with in one week. You should NOT develop severe pain, swelling or
redness at the site.
 Pain or discoloration in either of your legs
 Call 911 if you have shortness of breath or chest pain
Follow-up Care:
Contact your doctor for any follow-up that may be needed. The results of your
angiogram will be sent directly to your doctor.
If these symptoms occur or if you have any other questions or concerns call the
Interventional Radiology department at 414- 805-3704, Monday thru Friday from
7:00 a.m. to 5:00 p.m. Overnight, weekends, or holidays call the hospital operator
at 414-805-6700 and ask for the Radiology doctor on call to be paged.