How safe are Angiograms ?

[kristina]

Hello again,
I would like to ask another question.
Next month my husband and I are being checked-up for the transplant
and we both were already told that we both need an angiogram
where some contrast-liquid is being "put" into our body
to see (?) the function of the kidneys and the heart and other organs etc.
I was wondering: why would doctors want to see for example the function of my kidneys through an angiogram
when my kidneys have already failed anyway and I have been on dialysis for over one month already?
Why put a liquid into my body which could endanger my little kidney function left, which still assists me even now ?
At the moment I can't quite see the logic of it and I am wondering about this procedure? Why is it done ?
I have also read somewhere that an angiogram and its contrast-liquid could be dangerous to the function of other organs
and I feel quite restless to think that anything could happen to my husbands healthy kidneys
whilst he is going through medical procedures in order to donate one of his kidneys ?
How safe are these transplant-procedures and how safe are Angiograms ?
Thanks from Kristina.



EDITED:  Move to Transplant Topic.  Rerun, Admin.   

[MooseMom]

I was never required to have an angiogram as part of my pre-transplant workup, and I've never heard of a potential donor being required to have one, either.

Is this common practice in the UK?  Anyone know?

Please ask your transplant team exactly why you and your husband are required to have this done.  I don't like the sound of this, frankly. 

[kristina]

Thank you MooseMum,
I shall try to find out whether this is common practice in the UK
and to be quite honest, I was very surprised when the doctor informed us about it.
I was too surprised to react straight away and wanted to think about it,
but the more I come to think about it, the more it unsettles me...
Thanks again from Kristina.

[Charlie B53]

I've had a number of angio's, a couple for my heart and more than a few for my legs.

There are different contrasting agents used for different 'pictures, your neph knows the differences, some are very hard on kidneys, others not so much.  Sometimes they use CO2 gas as a contrasting agent, there is no ill effect on any part of the body.

I wouldn't worry about it.  The worst part is having to lay fllat for hours afterwards to be absolutely sure the large hole they poke into the femoral artery seals well.  NO heavy lifting, etc., for the next week.

You both should do just fine.

[coravh]

I know that my transplant center required that every diabetic with over 25 years "experience" had to have an angio. Some dyes are less toxic than others. I was on dialysis at the time, so it didn't really matter. Amazingly enough, I needed 2 coronary stents and I didn't have any symptoms. This is why I had to do it. In the overall, it was much safer for me. So I had the transplant surgery with my 2 stents in place. And my cousin had to have some sort of flow test to double check how well her kidneys were functioning.

[Michael Murphy]

In 2008 I had a angiogram which turned into a angioplasty in which 6?stents were placed in my heart.  Despite the scare caused by the doctor saying oh no at the beginning of the procedure it went well.  Two points one you are awake for this procedure so I heard the doctor, two after the procedure he was running around show evry body my X-ray and proudly telling every one how he had done this.  In late 2012 I was in a car accident and had a complete rotor cuff tear in my right shoulder.  This is a major operation and the surgeon felt I needed a angiogram to confirm my heart was ok for the surgery.  Now while I was not yet on dialysis I was worried about the contrast and my kidney function.  So I had the nephrologist speak to the cardiologist about it.  SAMs surgeon same operating room no oh no.  Just when he was done same routine except that this time he was bragging about the X-ray he got on 10 cc's of contrast.  There was no change in my kidney function and I was cleared for the reconstruction of my shoulder.  Moral, make sure your surgeon knows to limit your exposure to the contrast and have the angioplasty done by the best doctor available. 

[kristina]

Thank you very much CharlieB53, coravh and Michael Murphy.
I did not know about the CO2 gas and I shall enquire about it, because if it leaves no side-effects.
That would be very recommendable for me because of my many allergies. Thanks again CharlieB53...
It is interesting, coravh, that you had no symptoms despite needing coronary stents...
I am beginning to see that an angiogram might be a good idea after all as a precautionary measure...
You were very lucky, Michael Murphy to "sail" through the angioplasty and needing several stents.
It must have been a great success for the doctor who operated on you!
Thanks for the ideas yougave me to make sure about limiting my exposure to the contrast-liquid
and have the angiogram done by the best doctor available to "read" the angiogram despite the limited contrast-liquid.
Thanks again from Kristina.

[cassandra]

My potential donor also had to go for an angiogram. I didn't get one at the time, but had had quite a few before that, and quite a few ops so the surgeon already knew me inside out so to speak.

   

[lainiepop]

Hi kristina. Im in the Uk i didnt have an angiogram as part of my tx work up neither did my donor despite being 66.

[cattlekid]

I had a heart attack in 2012 that resulted in angioplasty and an angiogram as well.  For the angiogram, I got an IV infusion prior to the procedure that was supposed to help with the dye issue and I was also scheduled for in-hospital dialysis both times immediately afterwards.  You have to lie still because of the hole in the artery so you might as well get a dialysis treatment in as well.

d

[noahvale]

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[kristina]

Thank you Cassandra, Iainiepop and cattlekit, I do appreciate your kind sharing of your experiences.
Could it be, Iainiepop that you did not need an angiogram, because your kidney function was better than mine ?
Or could it be that nephrologist have made new medical discoveries and now they apply these discoveries
by having prospective kidney-transplant-recipients undertake an angiogram ?
... I have researched a bit and have read, that kidney-transplant has become a medical and also a moral question,
because the life-donor donates one of his kidneys in an effort to better the life-quality of a kidney-patient ...
...but doctors need to check-up, that the kidney-recipient will be able to enjoy this kidney-donation for many years to come...
... Doctors cannot take the risk of transplanting a life-donation to a kidney-patient, who might die shortly after their kidney-transplant-operation...
...and therefore doctors need to make as sure as they possibly can, that the operation goes well for the kidney-recipient
and an angiogram before the transplant-operation, assures that ...

[MooseMom]

I would imagine that anyone who has agreed to allow their loved one's organs to be harvested and given to another person would want that person to be able to enjoy the new life their sacrifice has provided, so I don't quite understand why the recipient of a live donation would/should be subjected to more invasive pre-transplant procedures than a recipient of a cadaveric organ.

Perhaps different centers have different protocols.  I'd hope that if my center thought I was at some risk of cardiovascular events, they'd have required an angiogram.  However, I did list with two centers, and neither required an angiogram.  This baffles me, frankly.

[Michael Murphy]

one more thing after my first angio (plasty gram) I had to lay still for 12 hours so the femoral artery would not start bleeding, last angiogram they used a pressure bandage and I was allowed up in two hours.  I now hear it is possible to go through the wrist and the recovery is even easier.  Not my favorite procedure but far from dialysis my least favorite.

[coravh]

Forgot to add, I've also had something called mucomyst (sp?). I've had contrast since my transplant and this stuff helps to protect the kidneys.

[lainiepop]

Kristina they told me they only do angiograms if they believe there to be a problem but as both dad and i had normal blood pressure and low cholestrol etc they had no reason to think there was a problem. My gfr was around 8 at time of tx work up.

Dad ended up having a heart attack a year and a half after the tx and this was the first time i heard of an angio and asked why it was not done before. They said they never do angios unless they suspect a problem and dont do it as protocol in tx workups. Dad only ended up with one when they suspected he had actually had a heart attack after all.  Dad was relieved he was able to donate the kidney and recovered great after his bypass op was back to playing tennis every week a few months later. We are going to disney florida with him my mum and kids this christmas to celebrate it all. We r very lucky. He turns 70 in september and my creatinine last week was 76. The doctors told me dad would have had the heart attack regardless of donating or not and his kidney is fine plus i think he had speedier treatment because he was a donor! The gp was more cautious because he had donated. Had he not been a donor the signs might have been missed and he may have then ended up with a fatal attack so we are all pretty glad he never had an original angio!

[kristina]

Thanks again for your thoughts, MooseMom, Michael Murphy and Iainiepop.
I shall ask the doctors about this, but perhaps an angiogram might be medically necessary for me,
because I have a history of high blood pressure and I also have a medical history of cerebral haemmorrhages,
several years of chron osteomyelitis in my right ankle (until it was cured in 1987),
many years of ill-health resulting in a severe stroke at the age of only 38,
all due to my suffering from Systemic Lupus Erythematosus (SLE) plus Mixed Connective Tissue Disease (MCTD)
and several other connected diseases, which were only diagnosed a few years after I suffered these medical cathastrophies...
... I also suffered "a spot of" cancer almost three years ago and there I was very lucky, because "it" was diagnosed,
operated on and treated with radiography almost immediately after diagnosis...
My good luck has been so far, that I have always made a good recovery
from all sorts of medical  cathastrophies (touch wood that it may continue...)
and I always keep to my daily walks and my vegetarian diet and try hard to "get on" with my life ...
Thanks again from Kristina.