Causes: An abnormal result in a peripheral angioplasty can occur due to the following reasons:

• Narrowing and hardening of the arteries in the legs or arms due to the buildup of plaque in the walls of the arteries
• Blood clot formation
• Other diseases of the arteries
• Aneurysms (abnormal ballooning or widening of a part of the artery)
• Injury to the blood vessels
• Inflammation of the blood vessels
• Buerger disease (a rare disease caused by a small blood vessel getting swollen and inflamed)
• Takayasu disease (inflammation of large arteries like the aorta, which is the main artery of the heart carrying blood from the heart to the rest of the body)

Symptoms: The following symptoms may indicate the need for a peripheral angiography:

• Weakness in the legs
• Numbness in the legs
• Sores or ulcers, which may take a long time to heal
• Gangrene
• Erectile dysfunction in men
• Loss of hair on the legs
• Slow growth of toenails
• Brittle toenails
• Skin on the affected area is pale and bluish, or shiny in appearance

A peripheral angiography can be done in association with other diagnostic tests like:

1. Ankle-brachial index pressure: This is a quick, non-invasive method to check for the presence of peripheral artery disease.
2. Magnetic resonance angiography: A powerful magnetic field, radio waves, and a computer is used to evaluate the blood vessels and identify the abnormalities.
3. CT angiography: A contrast material is injected into the blood vessels and a CT scan is performed to help in diagnosing and evaluating any blood vessel diseases.
4. Doppler and ultrasound imaging: It is an imaging test that uses sound waves to estimate the blood flow through the blood vessels.

• You will lie on the x-ray table.
• You may be given a sedative before the procedure, to help you relax.
• The area of the procedure, which is most often the groin region, is shaved and cleaned.
• A local anesthesia (a numbing agent) is injected into the skin over an artery.
• A needle is placed in the above artery.
• A thin, plastic tube, known as a catheter, is passed through the needle into the artery.
• The catheter is guided into the area of the body that is being studied. The doctor can view the live images of the area on a monitor, and use them as a guide.
• A dye is injected through the catheter into the arteries.
• X-ray images of the arteries are taken.
• The dye makes the blocked or narrow portion of the arteries appear clearly on the x-rays.
• It is normal to feel hot or flushed for a few seconds after dye insertion.
• Some treatments can also be performed during the procedure such as:
• Injecting a medicine to dissolve the blood clot.
• Opening a blocked artery using a balloon.
• Placement of a small tube, known as a stent, into the artery to help it stay open.
• The catheter is removed once the procedure is completed.

The complications of peripheral angiography may include:

• Blood vessel damage at the site of needle and catheter insertion

• Injury to the blood vessels that are being tested

• Nerve injury at the needle puncture site

• Blood clot formation or excessive bleeding at the site of catheter insertion, causing reduced blood flow to the leg

• Allergic reaction to the contrast dye used

• Heart attack

• Stroke (interrupted blood flow to the brain)

• Hematoma (blood collection at the site of needle puncture)

• Damage to the kidneys 

• Loss of limb
  

• Pressure is applied on the puncture site for approximately 10 to 20 minutes after the procedure.

• A bandage is then applied to the wound.

• You will be asked to keep the leg that is being used for the catheter straight for at least six hours after the procedure.

• It is normal to have a small bruise at the site of the puncture.

• You will be closely monitored for any bleeding or swelling after the procedure.

• Drink lots of fluids once you go home.

• Avoid heavy lifting or other strenuous activities for 2 days after the procedure.

• Normally, you will be able to start with solid food and take your regular medications four to six hours after the angiogram.

• Avoid driving for at least two days after the procedure.

• The site of puncture may feel tender for a couple of days after the procedure.

• You can usually resume your daily activities the next day after the procedure.

• You can gradually resume your normal activities, allowing the incision to heal.

• If you notice any bleeding from the site of the puncture, lie flat and then press firmly on the bleeding spot.

• Contact your doctor immediately if you notice any of the following:

• The leg with the puncture tingles or becomes numb

• The foot turns blue or feels cold

• The puncture site swells up

• Fluid drainage from the puncture site

• Bleeding from the site of puncture does not slow down even after firmly pressing on it