Before Your Procedure

After a brief discussion with the nurse you will be taken into the Catheterization Lab and asked to
lie on a special X-ray table. The temperature in the room will be very cold. You will be attached to a heart monitor.

As this is a teaching hospital there may be other physicians, nurses and lab technologists involved in your procedure. All staff will be wearing gowns, masks and special aprons.

Your groin/wrist will be washed with a cold solution and sterile sheets will be placed over you. It is important that you neither move nor touch the top of the sheets once they are in place. You may be asked to lie with your arms above your head for a period of time. A nurse will be available to assist you.

During Your Procedure

You will be given medication to help you relax, but you will be awake during the procedure so that
you can follow instructions from the doctor and nurses. The doctor will administer freezing to your groin/wrist. A small catheter will be threaded through a blood vessel up to the heart. A contrast dye will be injected through this catheter to highlight the coronary arteries. Most patients experience a sensation of body warmth or the urge to empty their bladder as the dye is injected.

X-ray pictures will be taken throughout the procedure. The X-ray machine will move over you very close to your body.

During the procedure, you may be asked to take a deep breath and hold it for a few seconds, or to cough. It is not unusual to experience some chest pain. Inform the nurse if you experience any discomfort or have concerns.

The time for the procedure in the lab is usually between 30 to 90 minutes. If your condition is complex, your procedure will be longer.

Due to unforeseen circumstances there may be a lengthy wait in the lab waiting area or you may be
returned to your room until the lab is available.

After Your Procedure

You will leave the Catheterization Lab on a stretcher, and one of the following will happen:

• After an angiogram: The catheter will be removed and a special clamp or manual pressure will be applied.
• After an angioplasty: You will be transferred to a unit which specializes in catheter (sheath) removal if a groin insertion was used, or back to the sending unit if the wrist was used.

The nurse will frequently check your pulse, blood pressure, pulses in your feet or wrist, and the puncture site. If you are a patient in the Day Unit area, due to space constraints, only one family member or friend should be with you at a time. They may be asked to leave periodically in order for the staff to deliver care and allow the patient to rest.

Following a groin insertion:

• If the doctor used your groin (femoral artery), you must remain on bed rest for up to 6 hours after the procedure.
• It is important to keep your head on the pillow and your affected leg straight. You will be reminded frequently to do these two things to avoid bleeding from the puncture site.
• If you experience back discomfort, you can be repositioned with the help of a nurse, keeping your affected leg straight. The head of your bed may be elevated slightly.
• During this time you may sleep, read or rest. You will be given a snack.

Following a wrist insertion:

• If the doctor used your arm (radial artery) you will have a clamp applied to your arm in the lab to prevent bleeding.
• You will be on bed rest for approximately one hour after the procedure.
• It is important to keep your arm on the pillow and refrain from twisting your wrist. You may move your fingers. Your nurse will be available to assist you while the clamp is in place.
• During this time you may sleep, read or rest. You will be given a snack.

Ask your nurse for assistance as soon as you need to go to the bathroom. It is important not to sit up. The nurse will assist you in getting up once your bed rest is complete. You will be encouraged to walk around during the hour before discharge.

Activity

Following a groin (femoral) insertion:

• Limit the amount of stair climbing as much as possible. Try to climb the stairs only once on the day of your procedure.
• Do not lift anything heavy—greater than 10 lbs (4.5 kg) —for 48 hours.
• Apply pressure to your groin if you have to sneeze or cough hard for 48 hours. The easiest way to apply pressure is to make a fist and place it firmly on the groin area over the band-aid.

Following a wrist (radial) insertion:

• Do not lift anything greater than 10 lbs (4.5 kg) with the affected arm for 48 hours after the procedure. Avoid vigorous wrist movements of the affected arm.
• You may elevate your arm on a pillow to help prevent swelling.

Dressing

• You may remove the clear dressing or band-aid the day after the procedure, and replace it with a new band-aid.
• A small amount of dried blood on the old dressing and puncture site is normal.
• You may take a shower the day after your test, but do not allow the dressing to stay wet.
• Do not take a tub bath or cleanse the arterial puncture site for 48 hours after your test.
• You may re-apply a dry band-aid for a few more days in order to keep the skin clean and reduce the risk of trauma or infection. The band-aid may be removed 72 hours after the procedure.
• Try to avoid wearing tight or restrictive clothing over the puncture site.

Puncture Site

Examine the site every day and notify your nurse or physician if any of these problems develop:

• An expanding lump or persistent area of redness and warmth
• Yellow drainage from the wound site
• Worsening numbness in the leg, hand, wrist, or arm
• Severe discomfort at the puncture site

Bleeding

If any bleeding occurs while in hospital, please ring for your nurse immediately. If a small amount of bleeding occurs at the puncture site at home:

• For a wrist site, sit down immediately and apply firm pressure to your wrist with your fingers for ten minutes.
• For a groin site, lie down and apply pressure to your groin using a fist placed firmly on the groin area over the band-aid.

If the bleeding stops, remain quiet and keep your procedure leg/wrist immobile for two hours.