Invasive Angiogram

I have an invasive angiogram booked for August 1st, but am far from happy about the potential risk of a "serious complication" (basically stroke, heart attack or death). Does anyone know of definitive figures for the risk of these as those I have read seem to vary considerably?

[Chappychap]

The British Medical Journal published a good analysis of angiography risks.

As you'd expect it's a lot lower risk than open heart surgery, with major complications (stroke, heart attack, death) running at 1-2 events per 1000 procedures, compared to the 20 events per 1000 procedures that's used for the informed consent form that the patient must sign before open heart surgery..

The major risk factors for open heart surgery are age and co-morbities (see the EuroSCORE II risk analysis), the risk factors for angiography are different, with the two biggest additional risks being a history of previous bypass surgery and the angiography extending over unusually long time periods.

Life is full of risks, but it seems to me that the exceptionally high quality of diagnostic information that only an angiogram can provide makes it a risk worth running.

Good luck!

[Hidden in reply to Chappychap]

Thanks for the reply and information. I wasn't quite sure what you meant about 20 events per 1000 procedures. Do you mean that there is a 20 in 1000 (1 in 50) chance of a complication of any sort occurring, including minor complications? The reason that I am concerned about the angiogram is that it is investigational only. This means that if stents are needed, another procedure would be needed. So the expected risk is even higher.

[gilreid1 in reply to Hidden]

Maths is wonderful thing ; if the figure is one in fifty then forty nine chance of no problem. So glass half full or half empty. Either way the benefits of this better than not having a test. Try and think positive

[MountainGoat52 in reply to Hidden]

The figures Chappychap gave are a 0.1% to 0.2% risk for the angioplasty and 2% for open heart surgery. I was told 1% for OHS before I had my bypass, which my surgeon explained was for all cases, planned and emergency and for all ages. He rated the risk for me to be considerably less than 1%, so it was a no brainer to go ahead and have surgery.

Angioplasty is a very safe procedure. There was no question when I had it as I was having a heart attack at the time, indeed I was unaware such procedures even existed. Well you don't when life is going fine... then it all comes crashing down. One clot removed and two stents inserted was the beginning of my heart journey and I will forever be grateful.

[Dessert]

Hi! I’m aware that there are risks but I believe the benefits outweigh the risks . When they perform an angiogram they can see what’s going on . I insisted on having sedation which helped a lot as I was nervous.

What about going to a hospital where they do stents!

I was an inpatient in a hospital where they only did angiograms but no stentsThe docs wanted to perform my angiogram there but SIL insisted that would not do the angiogram in that hospital . So they transferred me to a hospital where they did stents . Then after the the angiogram and a stent , I was taken back to original hospital

[Hidden]

Dear Samazeuilh

Its a balancing game that sometimes to much information can take away the reasons of having the procedure done in the first place.

Your Heart Team / Cardiologist will be able to supply you with all the information and more that you require to make the decision to go ahead with the procedure.

They will not continue until they know that you are happy to go ahead, then and only then will you sign an agreement allowing them to do so.

There is a reason you have been put forward for this operation, knowing how interested you are in your own medical health, I suspect you already know that answer to why you are going for one.

Please take care, its not a very pleasant thing to go through but the information that they can get is invaluable.

[CyclingTime]

All I can add is that without my angiogram in January I would now be dead, the benefits far outweigh the risks

[Hidden in reply to CyclingTime]

Totally agree and it mirrors my thoughts to my own angiogram

[reidmar in reply to Hidden]

same here

[reidmar]

like others I wouldn't be here if I hadn't had mine, I was admitted same day and a quadruple bypass 2 weeks after my angiogram. definitely wasn't expected but grateful it happened.

[Digger0]

I am having my ASD closed via catheter, and my consultant said I was much more likely to get injured driving up the M6 etc from Derbyshire to Liverpool that to have problems from the procedure. As I'm really compromised at the moment, the risk is worth it. good luck.

[Kit2000]

Hi I had a CT scan with contrast first and then the consultant requested an angiogram as he wanted to see my heart in more detail, I was very nervous and had something to make me feel relaxed, on the day the angiogram went well and everyone in the theatre were all so calm and caring. I think when we have any health problems we have to trust those in the know, reading information on the internet is scary and filled my head full of fear.

After the procedure ( i had mine via the groin) some have it via the wrist, its very important to listen to the staff and follow their instructions.

I was informed that they had put a plug in the entry wound and this would help it heal quicker, I lay still for about 4 hours and didn’t have any bruises and then went home and rested for a week on advice of staff .

I had a lot of pain in the groin area days later and they took me into hospital and scanned the groin but nothing was a miss thank goodness.

As a result i was offered a stent but told it wouldn’t give me any better outcome than taking medication i opted for medication .

I hope you find the strength to follow the consultants advice and wish you luck we are all different but all here for each other i found the advice from people on here invaluable at the start of my journey and thank everyone for their support

[Hidden]

I understand your concerns but believe the risk of having an undiagnosed heart issue left untreated far out weight the risk of the procedure.

[seniorita]

I understand your concerns. Much depends on why they want to do it. It was recommended for me, after I was referred to the rapid access chest pain clinic because of chest pain I had experienced SIX YEARS earlier. I hasten to add that it was investigated at the time. I refused, and had a CT angiogram with contrast instead, which showed there was no problem. If you are having investigations you are probably having problems so maybe discuss with them any options. Good luck.

[Chrissca71]

have you asked the hospital if they do stents if needed. i went in to have an angiogram six weeks ago as an investigation which turned out i needed three stents which they did there and then i have COPD which could of been a risk but no problem and i was assured before the procedure that the risk was very low which reassured me and having this done possibly saved my live as my artery was very blocked and now i feel so much better ,dont worry about the what ifs but think positive could save my life if they find something

[Qualipop]

They are doing literally dozens of angiograms every day. Yes problems can happen but the risk is tiny. 1 or 2 per thousand.

[Cruiser25]

Hi Samazeuilh,

If I'm reading this correctly, you've had time to think about and consider this procedure.

Trepidation of the unknown is completely understandable. This procedure is only unknown for you at the moment. I wonder how climbing and descending the stairs in your house (oops if you live in a bungalow) compares risk -wise with Angiogram? One of these, most people would not give a second thought about, possibly even running up and down several times a day.

This procedure can reveal what other diagnostic procedures cannot. For instance IVUS (Intravenous Ultrasound), if this were used during Angiogram, it can look down the artery from the inside, pretty amazing, believe me I've watched this live from inside my own heart.

What I'm trying to reassure you about is, perspective and perspective. Would anyone on this forum prefer not to know what they know, or have experienced what they've experienced..... hell yes!

But would we swap what we know and what we've experienced for the alternative?

I'm absolutely convinced you'll be fine, our Cardiologists and Registrars are very, very skilful, yes they brush it off as "it's what we do", but we have the very best in the world in this country.

Good luck and don't forget to let us know how you get on.

[Hidden]

Thanks to all those who have replied on this thread. I have read and appreciate all the responses.

[simplysal]

Hi there, just to reassure you, I felt EXACTLY the same way!

Signing the consent form for it on the day broke me into a sweat. Who ordinarily wants to have it done? No one. But who would rather the alternative of not having it done and then something awful happening? No one.

I had mine done in November last year. Having kittens on the day.

Was wheeled in thinking ‘oh crap’, left there thinking ‘that was easy’. If I knew then what I know now, I wouldn’t have felt anxious at all.

We take risks every day of the week, stepping outside our door, getting into our car, boarding a plane, swimming in the sea. We think nothing of that because we are not told of the statistical risks before we do it.

Only difference with this is that the risks are verbalised to us beforehand. Makes us contemplate them more.

They say ignorance is bliss!

In all seriousness though, they don’t offer these investigations freely. There must be a clinical need for it. They must be concerned that something could be wrong for it to become indicated. They really are experts in this field. And we, as humble as we are, have to place our trust in them that they know what they’re doing.

I left the cath lab thinking I was a bad assss and could take on the world! Still flipping proud I went through with it (doubted my ability to even walk in through the doors on the day).

I’m very thankful I had mine. It found my LAD artery was 90% blocked! I could then have it treated.

It is no walk in the park and takes courage to do it……but if I could do it, I am sure anyone can!

Good luck for your procedure. I promise it is no way as awful as your mind could ever conjure up. All the best, Saly.

[sickandsore]

Tiny risk of severe complications. And look at it this way should you have any of those happen you are surrounded by a team more than capable of helping you.It’s rare those things happen but they have to tell you of potential risks.

I’ve had angiogram s and angioplasty I felt very safe. They wouldn’t put you through a procedure unless the risks were worth taking either. Best of luck on the 1st. X

[MountainGoat52]

Spot on... a 0.1% to 0.2% risk for ALL cases is an extremely low figure. 😀

[MountainGoat52]

I was still having my heart attack when they wheeled me straight off the ambulance and into the cath lab. I think they sussed I was doing okay as they asked me if I could get myself over from the trolley. A quick shuffle and I was there and the procedure got underway. I must say it was all very smoothly done. A quick shuffle onto another trolley and I was in resus inside half an hour being asked what I wanted for lunch. 😀

What surprised me when I had my heart attack was that it did not incapacitate me. I was able to phone 999, go upstairs to get myself a 300mg aspirin, open the front door and sit and relax and wait for the paramedics. Not exactly a one hit and you're out experience.

[bridgeit]

In my opinion (I am not medically trained), it's wise to ignore the numbers. Possible (not probable) risks listed with this kind of procedure, given its very nature, are I think calculable only against each individual's clinical situation rather than any general statistical probability. The playing field is anything but level because each case can differ widely.In my experience, medics always have to explain all risks to us prior to any procedure. Then we sign a form and in so doing indicate that our perspective on a tricky procedure is "yes, I'm comfortable with the remote possibility of a catastrophic outcome; please do proceed". Of course, the reality is that most of us prefer not to think about a poor outcome, instead focusing on the balance between an uninvestigated problem worsening and the remote risk of an investigation going awry.

Regarding an angiogram specifically, I had something similar called a venoplasty, where a catheter was inserted into my right groin, up a major vein and into the internal jugular vein deep inside in my head.

Oh, the risk list read to me attached to that necessary investigative procedure was lengthy. However, I was being attended by a super-skilled interventional neuro-radiologist. When I was advised that stroke was one risk of the procedure (among others) just before I signed the consent form ready to go into theatre, fully conscious throughout, I asked the following question:

"Am I in the right place, surrounded by the right people to immediately deal with the situation effectively should stroke or some other vascular injury occur?"

The neuro-radiologist smiled at me and said "yes, you are".

That was good enough for me.

My advice for what it's worth is: trust your specialists. They know what they're doing. You too will be in the right place with the right people around you to deal quickly with anything untoward, should it arise.

I hope your investigation proves as uneventful and highly informative as was mine!

[MountainGoat52]

I decided it was a HA when the pain started to go down my arms and it felt as though I was wearing a lead weight on my chest, probably an hour after onset. I was fully mobile during that time, actually packing my car!

When the paramedics arrived they asked me to score the pain out of 10... I said 5 as I can cope with dull pain. They had that down to a 3 in minutes. Brilliant guys, extremely professional and caring. I was not particularly concerned once they had it under control and even exchanged a few laughs with paramedic in the ambulance while I was blue-lighted to hospital. My son went in the ambulance with me and said it was all very bizarre!