The procedures this covers
Peripheral angiogram and intervention (arteries and veins of the legs, arms, kidneys, and dialysis access), coronary angiogram and intervention, venogram and venous stenting, device implants (loop recorder, pacemaker, ICD, CRT), and TEE with cardioversion. Every one is scheduled as outpatient, with nearly all patients home the same day.
Before your procedure — planning & lab work
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A planning visit reviews your history, medications, allergies, and prior imaging, and we go over the procedure, its benefits and risks, and the possibility of treating what we find in the same sitting.
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Simple lab work within a few weeks beforehand — blood count, kidney function, and blood sugar (plus an INR if you take warfarin). A pregnancy test is done for women of child-bearing age.
Your medicines — a plan made for you
At your planning visit we review every medication and give you a written list of exactly what to take, hold, or adjust, and when. In general:
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Aspirin: usually continued (sometimes started) — it protects arteries and stents.
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Other blood thinners (clopidogrel/Plavix, warfarin, apixaban, rivaroxaban): individualized. For many artery procedures we hold them for a few days beforehand; for device implants we often continue them, because that is safer than switching to a bridge. We give you your exact plan — never stop or change a blood thinner on your own.
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Metformin (for diabetes): held the day of the procedure and for about 48 hours after when contrast dye is used, with kidney function rechecked before you restart it.
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Insulin: the dose is adjusted for fasting — bring your insulin with you.
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Blood-pressure medicines: usually taken as normal with a small sip of water.
Eating & drinking
We give you specific instructions, but in general, for procedures with light sedation you may have a light meal up to about 6 hours before and clear liquids up to 2 hours before — and we encourage hydration, since being well-hydrated protects your kidneys and blood pressure. Recent studies suggest strict fasting may not be necessary for many catheter procedures, with better comfort and fewer drops in blood pressure or blood sugar. Two exceptions: a TEE with cardioversion requires fasting for at least 6 hours (a probe passes into the esophagus), and a loop recorder usually needs no fasting at all.
Protecting your kidneys & preventing infection
If your kidney function is reduced, we plan ahead — good hydration, the least dye necessary, and contrast-sparing techniques that keep the volume well within published CKD safe limits, and CO₂ angiography (zero dye) when a kidney can tolerate none. Kidney-protective vascular care → For a device implant, we may ask you to wash with an antibacterial cleanser for a day or two before and the morning of, to lower infection risk.
The day of — arrival & check-in
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Arrive about 1 to 2 hours before your scheduled time.
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Bring a current medication list, your insurance card and photo ID, and your device ID card if you have a cardiac device.
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A responsible adult must drive you home — you cannot drive yourself after sedation.
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You change into a gown, and we place an IV for fluids and medicines.
A safety pause before we start
Before every procedure the team performs a “time-out” to confirm your identity and the exact procedure, your consent and allergies, your relevant labs, and the access site — and, for device implants, that antibiotics are given within the hour beforehand to lower infection risk.
During your procedure
Most procedures use local anesthesia with light sedation, so you are relaxed but breathing on your own (a TEE-cardioversion uses deeper IV sedation; a loop recorder uses local only). We reach the problem through a small puncture — usually the wrist, groin, or foot — and image from the inside with intravascular ultrasound (IVUS) to treat precisely. Times vary: about 5 to 10 minutes for a loop recorder, 30 to 120 minutes for most artery and vein work, and 1 to 3 hours for a device implant.
Where your procedure takes place
Some procedures happen in our office-based lab (OBL) — a fully equipped catheterization lab in a familiar, streamlined outpatient setting where every patient goes home the same day. Others (coronary, carotid, aortoiliac, and device implants) are done in the hospital outpatient department (HOPD), which adds hospital resources — anesthesia support, larger-bore access when needed, blood bank, and backup — while still following a same-day pathway. The setting tells you where your procedure happens, not whether you will stay overnight.
Recovery & going home
After a short, monitored recovery — its length depends on the access site — we check the site, your pulses, and the treated limb, review your discharge medicines and written instructions, and confirm your ride is present. For device implants we take a chest X-ray to confirm the leads and check the device; after a TEE-cardioversion we make sure you are fully awake and review your blood-thinner plan.
See After Your Procedure — detailed recovery, warning signs & medication guidance →