Clinician Experience
Hello. I'm Dr R. I'm a Consultant Radiologist. That's a fully trained medical doctor who specialises in the many ways of imaging the body using X-Rays, Ultrasound, CT scanning or MR scanning. I’m an Interventional Radiologist who diagnoses and treats problems in arteries in order to avoid the need for surgery.When in the angiography room (which you might also hear called the interventional room, angio-, or fluoroscopy room) it's my job to do your angiogram and decide what the x-ray images that we have taken show and sometimes treat the problem I find. Patients come to us with different problems so the tests we do and what we are trying to show are various. The commonest tests done in this room are tests of the arteries (angiograms). A material (contrast medium) which shows up well on x-rays because it contains iodine, is used to outline the arteries that we're interested in. So, for example, if we inject contrast medium into a main artery of the leg with can see the blood circulation to the legs. We can inject the contrast medium into other arteries and veins; sometimes we examine other parts of the body including the kidneys and the bladder. I'm going to talk to you about exactly what I'm going to do when we meet.
Angiography studies of the legs require some minor preparation. You will be asked not to eat or drink for 4 hours before the procedure, in most cases you will also need to come into hospital for a short while. Usually patients have to change into a gown for the angiogram.
There will be other people in the room as we do your angiogram. I need a radiographer to help operate the equipment and a nurse to keep an eye on your comfort, blood pressure etc. There may be trainees and students working with me, after-all, we all have to learn, and the only way to learn many things in medicine is with real people, but this will all be explained to you. If you don’t want Students or Trainees to be present when you have your angiogram, you have the right to ask the staff in the room to ask them to leave.
I'll introduce myself and tell you what your doctors have asked us to do and explain how we will do the angiogram before you go into the interventional room. You can ask any questions and if you are happy I will ask you to sign a consent form. As every test and every patient is different, it's hard to give you much more information at this stage but I'll tell you what we do as we go along. You'll need to lie still on an x-ray table for sometime. Once you are on the x-ray table I need to clean the skin in your groin area and then cover you with sterile towels to prevent infection. I will be wearing a sterile gown and gloves also to prevent infection. Then I will numb the skin in your groin with a small injection; this may sting like a dentist’s injection, I will tell you before this happens.
Once the skin is numb, I can place a slightly bigger needle into one of the main arteries in your leg and though this I can place a fine wire and using the x-rays move this into the main artery of your abdomen, the Aorta. Over this wire I can then place a special tube, a catheter, which we will then use to inject contrast medium. None of this should hurt. Once the catheter is in position we can inject and take the x-ray pictures. I'll take a number of x-rays as I go. At the end of your test, I might have a clear idea of the result, and I'll tell you what I can see. Often it's only when I sit down and analyse your images later that I can properly decide what they show and write a report for your doctors. They'll have the result when you next visit for your follow-up appointment in out-patients and they will discuss that with you.
After the procedure is over, the catheter will be removed and the small hole in the artery in the groin will heal normally after some pressure from me using a bandage. We need to keep you lying flat for several hours while the hole heals properly. Any sudden or large movements may re-open to the hole so it is important to lie flat and still until you are told to start getting up. You will be allowed to eat and drink normally when you get back to the ward, you may even be allowed to go home the same day or if not, the morning afterwards.