The circumstances of a catheter-based procedure depend on the underlying condition. In some cases, catheter-based procedures may be performed in emergency situations, such as occurs after a heart attack or stroke. In other cases, they are performed as elective procedures meant to correct an existing condition or help reduce the risk of a more serious disease-related complication.

Before the day of a scheduled catheter-based procedure, patients (or the parents of an infant) should discuss the patient’s medical history with the physician and inform him or her of any medications being taken. Certain medications may need to be temporarily stopped or reduced. It is also recommended that patients with diabetes consult their physician regarding food and insulin intake, because people are usually asked to stop eating or drinking after midnight before the test.

Catheter-based procedures are performed in a hospital’s catheterization laboratory, which provides access to appropriate emergency facilities should problems arise.

On the day of the procedure, the patient is taken to the cool and sterile catheterization laboratory that may resemble an operating room with monitoring devices, video display equipment and x-ray cameras. A nurse or physician will explain what is going to happen, and the patient is encouraged to ask questions.

After the patient is made comfortable, an intravenous (I.V.) line is inserted into the patient’s arm. The I.V. allows the physician to give the patient a mild sedative and other necessary medications during the procedure. Small devices will be taped to the patient’s body, which allow the physician to monitor heart rate, rhythm and blood oxygen level.

The physician usually uses the groin/upper thigh area to insert the catheter that will be threaded to the heart, but some physicians may choose to use the elbow or wrist. The area chosen will be cleaned, shaved, swabbed with germ-killing solution and numbed with a local anesthetic. The catheter is then fed through the artery in that area (e.g., the femoral artery in the groin/upper thigh) and up into the heart. There may be some minor discomfort during this period.

After the catheter is in place, the necessary tests/procedures are performed. The optimal procedure for a given patient depends on the severity of the condition, the type of obstruction, the patient’s medical history and other factors. After these procedures are complete, the catheter is removed.

After the procedure is completed, the patient will be moved to a cardiac recovery room. He or she may feel groggy from the sedative. The catheter insertion site may be bruised and sore.

If the groin area was used as the point of catheter insertion, then the patient will be instructed to lie in bed with legs out straight. The physician may choose to use one of two techniques for removing the sheath that was placed at the initiation of the procedure. The traditional technique is to wait until the effects of the anticoagulant have passed (four to six hours) and then to apply pressure while removing the sheath from the femoral artery. A newly developed technique allows the sheath to be removed immediately after the procedure through the use of hemostatic devices that seal or stitch the femoral artery.

If the wrist or arm was used as the point of catheter insertion, then the patient does not need to stay in bed. Throughout the post-procedure monitoring, the point of catheter entrance will be checked for bleeding, swelling or inflammation. Vital signs will be continuously monitored during this observation period. The patient may stay overnight for further observation and is then typically free to go home. In many cases the procedure can be performed on an outpatient basis, with the patient discharged two to four hours later.

Patients are given instructions from the medical staff regarding the following: