What are the logistics?
Procedures are performed by a neurointerventionalist in an angiography suite, with the support of a team of nurses, technologists and possibly anesthesia staff depending on the procedure.
How do I prepare for an endovascular procedure?
Endovascular procedures and angiography generally require a pre-operative history and physical within 30 days of the procedure, as well as blood work.
- Eating and drinking – Patients should not eat or drink for 8 hours prior to the procedure. Patients should drink extra fluids for 2 days before that, unless a physician has prescribed fluid restriction.
- Medications – Medications should be taken the morning of the procedure with only small sips of water. If diabetic and taking glucophage (Metformin), the morning dose should NOT be taken. If taking insulin, the dose will likely need to be modified for the day of the procedure. If started on aspirin or clopidogrel (Plavix), DO NOT STOP these medications prior to the procedure.
- Allergies – If you are allergic to x-ray dye, you will need medications before the procedure in order to prevent an allergic reaction.
- Kidney function – If you have a history of renal insufficiency, additional fluid or medications may be necessary.
- Smoking – No smoking for at least 72 hours, preferably 10 days, prior to your procedure.
- Driving – No driving for 24 to 48 hours after general anesthesia, or if you are taking narcotics. You will need a driver to take you home when you are discharged from the hospital.
What happens on the day of the procedure?
If the procedure will be performed under general anesthesia, check in at the Pre-operative Care Center (POCC) 2 hours prior to your procedure time. Otherwise, registration is typically 1.5 hours prior to your procedure time.
- A nurse and/or anesthesiologist will review your health history as well as your medications and allergies.
- The neurointerventionalist will meet with you prior to the procedure to answer any questions you may have.
- After the procedure you will go to the post-anesthesia recovery area. It is not uncommon to feel groggy and fatigued following neurointerventional procedures. Headaches may occur in some patients. If needed you may be sent home with additional medication to treat headaches.
After-care
- Drink plenty of fluids.
- Gradually increase activity as tolerated.
- Avoid lifting objects heavier than 10 pounds for 1 week.
- Avoid bending your leg at the hip and straining.
- Support your groin site with your hand when you cough, climb stairs or change positions for the first 48 hours following your procedure.
- Keep the puncture site dry. If you have bleeding or swelling under the skin, lie down and put firm pressure slightly above the puncture site for 10 to 20 minutes.
- You may shower 24 hours after your procedure. Gently wash the site with warm water. Dry gently. If there is still a slit in the skin cover with a bandage until it closes. You may shower. Do not take tub baths, swim in lakes or pools until your puncture site is healed without a scab.
- No driving for 24 to 48 hours after general anesthesia or if you are taking narcotics.
- You should not drink alcoholic beverages or make critical decisions or sign important documents for 48 hours.
Follow-up
You will need to have follow-up after almost all neurointerventional procedures. Typically, we see patients in our outpatient clinic at 30 days following most treatments. For brain aneurysms, lifelong follow-up imaging is recommended. This typically occurs at 6 months, 2 years, 5 years, 10 years, and 20 years following treatment.
