Venogram

Patient Information Leaflet

Introduction

You have been given this leaflet as your doctor has suggested you would benefit from having a venogram This leaflet gives more information on what will happen to you before and after the procedure. It is designed to make sure that you know as much as possible about the procedure before you agree to it and sign the consent form.

What is a venogram

A venogram uses X rays to look at the veins that are connected to your heart. It will show any narrowing or blockages in the veins, that connect to your heart. It gives us a ‘road map’ of your veins

Why do I need a venogram?

We need to check your veins have suitable access for the pacemaker lead(s) to your heart.

Consent

We must seek your consent for any procedure or treatment beforehand which will be a two-stage process.

Stage one will be with your doctor in a clinic setting where they will explain the risks, benefits and alternatives where relevant, before they ask for your written consent. If you are unsure about any aspect of the procedure or treatment proposed, please do not hesitate to ask for more information.

Stage two will be a re-confirmation when you attend for the procedure and will be undertaken by a healthcare professional (either physiologist or the operator 

What are the benefits of having this procedure?

By looking at the blood flow in your veins we can decide plan what is the most appropriate treatment for you.

What are the risks of having this procedure?

As with all procedures or operations, there is an element of risk. In most cases this is very small. These risks include:

• Allergic reaction. The dye, or contrast, we use to look at the coronary arteries contains traces of iodine- some people can have a sensitivity or allergy to iodine. Please tell staff if you have an allergy to iodine. (If you are allergic to strawberries, shellfish or TCP this may be an indication of an allergy to iodine.)
• There is a small risk of damage to the vein in the arm requiring surgical repair.
• Bleeding under the skin at the wound site (haematoma)- this should improve after a few days
• Bruising- it’s common to have a bruise on your wrist for a few weeks
• A venogram involves a low dose of radiation, about the same as the amount of radiation you would normally get in 6 months of natural background radiation. X-rays can carry a risk of damaging the body’s cells, potentially causing cancer. The benefit of the test far outweighs the risks.

What if I decide not to have a Venogram

The venogram will give your cardiologist the best images of your veins. Without this information, they may not be able to advise you on which treatment plan is best for you. However, there are other types of scans which may provide some useful information about your veins; your cardiologist will have discussed these with you, or you may have already had this type of test.

On the day of the procedure:

• Eat as normal.
• Drink as normal.
• Bring all medication with you.
• Please take your normal medications, with a sip of water, on the morning of your procedure- see the note regarding Warfarin, anticoagulation and Metformin
• Have a bath or shower
• Remove jewellery, contact lenses, make-up and nail varnish. Wedding rings can remain but will be taped for the procedure.
• Be prepared to stay overnight, pack a small bag
• Bring a book or something to do whilst you wait
• Bring reading glasses.
• Avoid bringing large sums of money or valuables

Medication

What to do if on Warfarin or newer anticoagulants (NOACs):

• Stop anticoagulation (Apixaban, Dabigatran, Edoxaban or Rivaroxaban) 48 hours before the procedure
• Warfarin, please contact the day case unit 01384 456111 Ext 2573 or the Anticoagulation team Ext 2380 to discuss when to take your last dose.
• Diabetes
• Eat and drink as normal.
• Take your diabetic medication as normal.
• Stop taking Metformin 48 hours before procedure and 24 hours post procedure
• Remember to bring all your diabetes medication, dextrose tablets and blood testing equipment
• Your blood glucose will be tested by a finger prick when you arrive and monitored
• Usually, we will try to put you first on the list

What happens on the day:

• We will provide you with a gown
• A small canula (tube) will be inserted into a vein in your arm, this will allow us to give medication
• Pre-procedure tests will include blood pressure, temperature, ECG, height and weight
• Please advise us if you have any allergies
• A health care professional will discuss your stage two consent. Please use this opportunity to raise any concerns that you may have

What happens during the procedure

The procedure is performed in a dedicated Xray room within the Cardiology Department. You will be cared for by a team of doctors, nurses, radiographers and cardiac physiologists.

• You will lie on an X-ray bed
• Your ECG, blood pressure and oxygen levels will be monitored throughout the procedure.
• You may notice a warm flushing feeling when the dye is injected. You may also notice/ feel the sensation that you have passed water. This is just a feeling; you will not have wet yourself. We will warn you when/ if this may occur.
• You will be taken back to recover in the day case unit

What happens after the procedure?

• You will be taken back to recover in the day case unit
• Your heart rate, blood pressure and wound site will be monitored.
• You will be given something to eat and drink.

What happens after the venogram

The doctor will discuss the results with you.

Going Home Advice

late adverse reaction

If taking any anticoagulation medication (rivaroxaban, dabigatran, apixaban, edoxoban  or warfarin) these can be restarted the following day. DO NOT take Metformin for 24 hours.

Diabetic patients:

You will be discharge when you are eating and drinking normally and your blood glucose is at a safe level.

However, if you are unwell with:

• Continuous vomiting /diarrhoea or high fever
• Unable to keep food down for 4 hours or more
• High blood glucose (>15mmol)
• High ketones (0.6mmol)

You should seek medical help. Contact your usual diabetes nurse or doctor

How to contact us:

Cardiology Day Case Unit

Russells Hall Hospital

Dudley

DY1 2HQ

Tel: 01384 456111 Ext 2573

Wednesday & Thursday 08.00 – 20.00

Cardiology Ward

Russells Hall Hospital

Dudley

DY1 2HQ

Tel: 01384 456111 Ext 2138

Additional information:

British Heart Foundation

Tel: 0808 802 1234

www.bhf.org.uk

If you have any questions, or if there is anything you do not understand, please contact the Russells Hall Hospital switchboard number on 01384 456111 and ask for the relevant department who issued this leaflet.

If you have any feedback on this patient information leaflet please email dgft.patient.information@nhs.net

This leaflet can be made available in large print, audio version and in other languages, please call 0800 073 0510.