Interventional Radiology and Fluoroscopy
Please read the following information carefully
Before this appointment you may have had an MRI scan, CT scan or an ultrasound scan of your blood vessels. This was to help us plan your treatment.
The majority of procedures will be done as day cases; this will usually be determined by a telephone pre-assessment conversation.
It may be better for you to stay overnight, depending on your circumstances, or if the procedure is complex or takes place in the afternoon. You will be notified if this is necessary during your pre assessment and in your letter.
Occasionally due to unforeseen circumstances a day case patient may be required to stay in overnight. This will be discussed with you and a bed arranged on an appropriate ward.
The radiology day unit is a small area, for this reason your relative/friend is welcome to accompany you when you arrive, but they will not be able to wait with you all day.
If this concerns you please contact the Radiology Day Unit Sister before your admission to discuss this on 01642 854332.
Medication
Patients taking warfarin or other anti-coagulants (blood thinners): eg acenocoumarol
(Sinthrome), phenindione, dabigatran (Pradaxa), apixaban (Eliquis), rivaroxaban (Xarelto).
If you are taking one of these drugs and have not already received specific instructions, please call us on 01642 854822.
Aspirin or Clopidogrel (Plavix)
Many of our patients are already on aspirin OR clopidogrel (Plavix), if so, please continue it unchanged.
If you take BOTH aspirin AND clopidogrel please ring Radiology Day Unit Sister before your admission to discuss this on 01642 854332.
If you are not already on aspirin or clopidogrel (Plavix), please take aspirin 300mg on the day of your procedure, unless you are unable to for medical reasons (eg allergy). If you are allergic to aspirin please let us know on arrival.
Diabetes controlled with diet or oral medication (tablets): You should continue with your normal regime.
Insulin controlled
For morning appointments, you should continue as normal, taking your insulin and breakfast no later than 7a.m. For afternoon appointments you should have your insulin and a light lunch no later than 12 noon.
Before your procedure
You will normally be admitted to the day unit or ward a few hours before the procedure to check your general health and carry out any necessary tests.
- Morning appointments
You may have a light breakfast for example tea and toast no later than 7am. - Afternoon appointment
You may have a light lunch such as sandwiches before 12 noon.
You will be seen in the x-ray department by a Nurse and Doctor, the procedure will be explained to you, and you will be asked to sign a consent form. This is to ensure you understand the procedure and its implications.
If you have any worries or questions at this stage do not be afraid to ask. We would like you to be as relaxed as possible and do not mind answering any of your questions.
During the procedure
The radiologist (x-ray doctor) will inject local anaesthetic into the skin of the groin or arm, numbing the area. A puncture is made into the blood vessel of the groin or arm and a long fine tube (catheter) is inserted. X-rays are used to position the catheter and carry out the procedure which may include an angiogram / angioplasty / stent.
Angiogram
With the tube in position dye is injected into the blood vessels and x-ray pictures are taken. The dye may make you feel hot for a few seconds, but this will soon pass. You may feel as if you have passed urine, this feeling is common, but nothing will have happened.
When the test is over, the dye passes out of the body in the urine (but you will not notice this and the urine will not change colour).
Angioplasty
This is like an angiogram but may take a little longer. This involves a balloon being passed into your blood vessel on the end of a tube. The balloon is then inflated to treat a narrowed or blocked vessel.
Depending on the result of the angioplasty it may be necessary to insert a special device called a stent.
Stent
A stent is a small metal mesh tube that expands in your blood vessel to keep it open and allow the blood to flow better (it is like metal scaffolding to hold vessels open). It is fed into your artery the same way as an angioplasty balloon.
Afterwards; (angiogram, angioplasty, stent)
You will be taken back to the ward or day unit to rest for a few hours. It is important that you lie flat so that the puncture site does not bleed again. The nursing staff will check the puncture site and take your pulse and blood pressure at regular intervals. We will give you an aftercare information leaflet before you leave us.
The majority of procedures will be done as day cases; however, it may be better for you to stay overnight, depending on your circumstances, or if the procedure is complex or takes place in the afternoon.
Important notice for day-case patients
You must arrange for a relative or friend to collect you after your procedure (to accompany you home). It will also be necessary for a friend or relative to remain with you at home until the following morning.
You must not drive yourself home or use public transport by yourself.
The person collecting you should telephone the ward or radiology day unit on 01642 854332 to find out when you can go home.
If you cannot make these arrangements please contact the x-ray department on 01642 854822 as your examination may need to be rearranged.
Are there any risks or complications?
The radiologist will talk to you individually. All risks and complications are explained before the procedure and before you sign the consent form. Please do not hesitate to ask any questions you may have.
Some degree of bruising is quite common and this normally disappears in a few days.
Occasionally angioplasty is not successful, usually if this happens, the circulation of blood is unchanged and so you will be no worse. After an unsuccessful procedure other treatments may need to be considered.
Very rarely the procedure is not successful and the circulation actually worsens. If this is a particular risk in your case, your Radiologist will discuss this with you.
Further information
For further information you may wish to visit the following websites and look at the
‘patients’ sections. However as these are not our websites, we cannot guarantee the content.
- Please visit: www.bsir.org
- Please visit: www.rcr.ac.uk
- Please visit: www.sirweb.org
- Please visit: www.vascularsociety.org.uk
Radiation dose and risk
X-rays use ionising radiation which can cause cell damage that may, after many years or decades, turn cancerous. The risk of this happening is very small compared to the normal lifetime risk of developing cancer which is 1 in 2.
We are also all exposed to background radiation every day. The risk of long-term effects is considered when the healthcare team decide whether someone needs an x-ray examination and radiation doses are kept as low as possible.
For this examination radiation dose levels are typically equivalent to around 1-2 years of background radiation. The associated risk is less than 1 in 1000 – Low.
Is there anything I should tell the staff?
For patients who have ovaries and are between the ages of 12 and 55, the x-ray department has a legal responsibility to ensure that this examination is performed within TEN DAYS of the first day of your menstrual period.
Contact us
If you require further information, please contact us on:
Telephone: 01642 854822
Email: [email protected]
Patient experience
South Tees Hospitals NHS Foundation Trust would like your feedback. If you wish to share your experience about your care and treatment or on behalf of a patient, please contact The Patient Experience Department who will advise you on how best to do this.
This service is based at The James Cook University Hospital but also covers the Friarage Hospital in Northallerton, our community hospitals and community health services.
To ensure we meet your communication needs please inform the Patient Experience Department of any special requirements, for example; braille or large print.
T: 01642 835964
E: [email protected]