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Femoral angiograms, work-up

  1. History and examination
  2. Non-invasive vascular lab. ABIs and segmental pressures pre-angio.
  3. Bloods - FBC, U&E, Coag screen, G&H. Risk factors-fasting glucose and lipids
  4. Informed consent from patient, record side of angio in notes and consent form
  5. Mark side of angio on patient and initial mark, see 14.3.
  6. Old angios to accompany patient
  7. 1 L of NaCl 0.9% IV for 12 hours prior to angiogram (contrast is nephrotoxic especially in volume depleted patients)
  8. Prophylactic, Co-Amoxiclav 750 millegrammes PO, morning pre-angio 07:00 hr
  9. Bed rest for 12-24 hours post angio
  10. Patient who are Heparinised, stop Heparin IV at midnight and check coag in the morning pre-angio. INR (especially important if patient has been on Warfarin) must be $<$ 1.2-1.4

Post angiogram, check groin for bleeding / haematoma. Check peripheral circulation

Angioplasty as above. Beware risk of Retroperitoneal Bleed, Groin False Aneurysm and distal ischaemia.



Adrian P. Ireland