Catheterization Lab Services

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Services offered in the Cardiac Cath Lab

Cardiac Catheterization

What is the purpose of this test?

The purpose of cardiac catheterization is to find out if you have disease in your coronary arteries, which supply the heart muscle with blood. This test can pinpoint the size and exact location of blockage that may have built up in your coronary arteries from atherosclerosis. A cardiac catheterization will determine if angioplasty, bypass surgery, or medical treatment is needed to treat the blockage. Other tests are performed during the catheterization. An x-ray test called a ventriculogram measures how well blood is pumped from the left ventricle to the aorta, and out to the rest of the body. A cardiac catheterization also identifies problems with the heart's valves.

What can I expect during the test?

In the prep/recovery area, electrodes (small round pads) and EKG (electrocardiogram) leads (wires) will be applied and these leads will be connected to an heart monitor that continuously monitors your heart rhythm. A blood pressure cuff and a finger probe will be applied to monitor your blood pressure and oxygen saturation during the procedure. You will be given medication in your IV (intravenous) for comfort but will remain awake during the procedure. Once in the cath lab, you will lie on a narrow table beneath an x-ray camera. The temperature in the catheterization lab is kept cool so the equipment does not overheat. Your wrist or groin will be prepped and you will be covered with a drape from chin to toe. The physician will numb your wrist or groin area with a medication, which may cause a mild burning sensation.

The cardiologist will insert a plastic tube called an introducer sheath into the left or right groin (femoral artery) or the left or right wrist. A guidewire and a catheter are gently inserted through the sheath then threaded through the arteries to the heart while the doctor watches on the imaging monitor. Blood vessels have no pain nerves so you won’t feel them moving through the artery. Catheters and wires will be removed and replaced several times to reach each coronary artery. X-ray dye will be injected through the catheter into the coronary arteries and x-ray images will be taken. You may feel a warm sensation when the dye circulates through your body. Several images (angiograms) are taken of each artery. The angiograms will show the amount of narrowing in the artery and the exact location. Also, pressures within the heart chambers will be measured. You may be asked to “take a deep breath and hold it”. You may also be asked to turn your head from side to side.

In most cases the doctor will review the angiograms then discuss the results with you and your family soon after the procedure is completed.

What can I expect after the test?

To prevent bleeding, the site may be closed with a special closure device, or manual pressure will be held to the insertion site for approximately 10 minutes. A sterile dressing will be placed over the site. Depending upon the results of the catheterization the sheath may remain in place for intervention.

Your heart rhythm blood pressure and oxygen saturation and pulses will be monitored frequently during your recovery period. The insertion site will be checked frequently for bleeding and pulses in your feet will be checked to assess circulation. The recovery period usually takes about 2 hours if a closure device was used. If manual pressure was held, you will lie flat up to 4-6 hours. You will be encouraged to drink fluids to prevent dehydration and help flush the dye through your kidneys.

The results of the test will determine what happens next. If an immediate intervention is deemed necessary, you will be transported by ambulance with paramedics or helicopter to an interventional facility such as Hershey Medical Center or another facility of your choice.

You may be discharged home and have further intervention done on an outpatient basis or be treated with medical therapy and risk factor modification. Specific discharge instructions will be given to you and your family concerning your level of activity and when you may return to work and resume driving.

Is there any thing I need to do to prepare for the test?

  • You will need to make arrangements to have someone drive you home and stay with you overnight. Please inform the cath lab if this is not possible at (717) 316-3551.
  • Do not eat or drink anything after midnight except sips of water for medications in the morning of the procedure.
  • Take your morning cardiac medications, including aspirin, with a sip of water. Hold diuretics (Lasix, Hydrochlorothiaziside or HCTZ), Metformin (Glucophage, Metformin, Avandament, Fortamet, Glucovance, Actoplus Met, Prandimet, Janumet, Metaglip) and oral hypoglycemic medications, as well as any insulin.
  • Bring all your medications in their original containers with you to the hospital, including the ones you stopped before the procedure. This also includes all over the counter medications and herbal supplements.
  • If you are taking Coumadin, your physician will instruct you on the dose changes prior to the procedure. Generally it is held 3 days prior to the procedure.
  • A Cardiovascular nurse will contact you one business day prior to your procedure to give you a time to report to the hospital and review your pre cath instructions. If a nurse does not call by 6 p.m. the night before your procedure, please call (717) 316-3711 and have the operator page the cardiovascular supervisor on-call. The supervisor will call you back and review the instructions at that time.
  • You will report directly to the Cardiovascular Lab on the 2nd floor of the Hospital.
  • Should you have any questions, please call the Cardiovascular Lab at (717) 316-3551. When the department is closed you may leave a message, or for more timely needs call (717) 316-3711 and have the cardiovascular supervisor paged.

When will I receive the results of the test?

Test results will be reviewed immediately after the procedure by the cardiologist performing the catheterization. The results will be discussed with you and your family while you are still in the recovery area. A copy of the report will be sent to your family physician.

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Vascular Angiogram

What is the purpose of this test?

An angiogram is an imaging test that uses x-rays to view your body’s blood vessels. Physician’s often use this test to study narrow, blocked , enlarged, or malformed arteries in many parts of your body, including your brain, heart, abdomen, kidneys and legs.

What can I expect during the test?

In the prep/recovery area, electrodes (small round pads) and EKG (electrocardiogram) leads (wires) will be applied and these leads will be connected to an electrocardiogram machine that continuously monitors your heart rhythm. A blood pressure cuff and a finger probe will be applied to monitor your blood pressure and oxygen saturation during the procedure. You will be given sedation in your IV for comfort but will remain awake during the procedure. Once in the cath lab, you will lie on a narrow table beneath x-ray cameras. The temperature in the catheterization lab is kept cool so the equipment does not overheat.

Your groin will be prepped and you will be covered with a drape from chin to toe. The physician will numb the groin area with a medication, which may cause a mild burning sensation. An introducer sheath will be placed into the left or right groin (femoral artery). A guidewire and a catheter are gently inserted through the sheath then threaded through the arteries to the desired location while the doctor watches on the imaging monitor. Blood vessels have no pain nerves so you won’t feel them moving through the artery. Dye will be injected through the catheter and x-ray images will be taken. You may feel a warm sensation when the dye circulates through your body. Several images (angiograms) are taken of each artery. The angiogram will show the amount of narrowing in the artery and the exact location. You may be asked to “take a deep breath and hold it”. It is very important to hold as still as possible so the images are not distorted by the movement.

What can I expect after the test?

To prevent bleeding the site may be closed with a special closure device or manual pressure will be held to the insertion site for approximately 10 minutes. A sterile dressing will be placed over the site. Your heart rhythm, blood pressure and oxygen saturation and pulses will be monitored frequently during your recovery period. The insertion site will be checked frequently for bleeding and pulses in your feet will be checked for to assess circulation. The recovery period usually takes about 2 hours if a closure device was used. If manual pressure was held you will lie flat up to 4-6 hours. You will be encouraged to drink fluids to prevent dehydration and help flush the contrast through your kidneys.

The results of the test will determine what happens next. You may be discharged home and have further intervention done on an outpatient basis or be treated with medical therapy and risk factor modification.

You may experience some soreness and bruising at the insertion site. This is temporary and should resolve within 2 weeks. For any bleeding emergencies call 9-1-1 immediately. Call your doctor immediately if your leg becomes pale, cold, painful, or numb or if you develop a fever or if you experience drainage or swelling at the insertion site.

Specific discharge instructions will be given to you and your family concerning your level of activity and when you may return to work and resume driving.

Is there any thing I need to do to prepare for the test?

  • You will need to make arrangements to have someone drive you home and stay with you overnight. Please inform the cath lab if this is not possible at (717) 316-3551.
  • Do not eat or drink anything after midnight except sips of water for medications in the morning of the procedure.
  • Take your morning cardiac medications including aspirin with a sip of water. Hold diuretics (Lasix, Hydrochlorothiaziside or HCTZ), Metformin (Glucophage, Metformin, Avandament, Fortamet, Glucovance, Actoplus Met, Prandimet, Janumet, Metaglip) and oral hypoglycemic medications, as well as any insulin.
  • Bring all your medications in their original containers with you to the hospital, including the ones you stopped before the procedure. This also includes all over the counter medications and herbal supplements.
  • If you are taking Coumadin your physician will instruct you on the dose changes prior to the procedure. Generally it is held 3 days prior to the procedure.
  • A Cardiovascular nurse will contact you one business day prior to your procedure to give you a time to report to the hospital and review your pre cath instructions. If a nurse does not call by 6 p.m. the night before your procedure, please call (717) 316-3711 and have the operator page the cardiovascular supervisor on-call. The supervisor will call you back and review the instructions at that time.
  • You will report directly to the Cardiovascular Lab on the 2nd floor of the Hospital.
  • Should you have any questions, please call the Cardiovascular Lab at (717) 316-3551. When the department is closed, you may leave a message, or for more timely needs call (717) 316-3711 and have the cardiovascular supervisor paged.

When will I receive the results of the test?

Test results will be reviewed immediately after the procedure by the cardiologist performing the catheterization. The results will be discussed with you and your family while you are still in the recovery area. A copy of the report will be sent to your family physician.

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Vascular Angioplasty and Stenting

What is the purpose of this procedure?

Angioplasty is used to treat peripheral arterial disease (PAD), which is another name for hardening of the arteries involved in supplying blood to your limbs or to organs in your body other than your heart. Your arteries are normally smooth and unobstructed on the inside, but as you age, plaque (made of cholesterol, calcium and fibrous tissue) can build up in the wall of your arteries. This process is called atherosclerosis, or hardening of the arteries. When plaque builds up enough to reduce blood flow through the artery, it can cause pain and damage to the part of the body the artery supplies.

As an alternative to vascular bypass surgery, your physician may recommend angioplasty to treat the narrowed arteries. For certain types of blockages, angioplasty has some advantages when compared to bypass surgery, which also treats narrowed arteries. Angioplasty can be performed while you are awake so there is no risk of receiving general anesthesia. Also because angioplasty does not require a large incision the recovery period is faster and patients generally go home the same day. Nevertheless, in some circumstances, bypass surgery may be a better option. Your vascular surgeon will help you decide what alternative is best for your individual situation.

What can I expect during the procedure?

In the prep/recovery area, electrodes (small round pads) and EKG (electrocardiogram) leads (wires) will be applied and these leads will be connected to an electrocardiogram machine that continuously monitors your heart rhythm. A blood pressure cuff and a finger probe will be applied to monitor your blood pressure and oxygen saturation during the procedure. You will be given sedation in your IV for comfort but will remain awake during the procedure. Once in the cath lab, you will lie on a narrow table beneath x-ray cameras. The temperature in the catheterization lab is kept cool so the equipment does not overheat. Your groin will be prepped and you will be covered with a drape from chin to toe.

The physician will numb the groin area with a medication, which may cause a burning sensation. An introducer will be placed into the left or right groin femoral artery) A guidewire and a catheter are gently inserted through the sheath then threaded through the arteries to the desired location while the doctor watches on the imaging monitor. Blood vessels have no pain nerves so you won’t feel them moving through the artery. Dye will be injected through the catheter and x-ray images will be taken. You may feel a warm sensation when the dye circulates through your body. Several images (angiograms) are taken of each artery. The angiogram will show the amount of narrowing in the artery and the exact location. You may be asked to “take a deep breath and hold it”. It is very important to hold as still as possible so the images are not distorted.

The physician then inserts a balloon catheter over the guidewire or through the guide catheter. The balloon catheter carries a deflated and folded balloon on its tip. It is guided to the narrowed segment of your artery. The balloon is inflated possibly several times until the plaque is flattened against the walls of the artery. This process usually takes a few minutes. Your artery may stretch and your blood flow through the artery stops when the balloon is pushing your artery open. This may cause pain but should go away when the balloon is deflated and normal blood flow resumes.

After an angioplasty there is a risk of re-narrowing or restenosis of the narrowed artery. It can happen soon after or months to years later. Sometimes the physician will need to brace the artery open with a tiny mesh tube called a stent. It looks like a tiny spring and comes in all sizes.

The angioplasty balloon is removed and a stent balloon is inserted through the catheter. When the stent balloon is at the blockage in the artery, the balloon is inflated inside the stent and this expands the stent. The balloon is then deflated and the catheter removed. The stent stays in place inside the artery wall. The artery wall will grow over the stent and prevent it from moving. If blood-thinning medication has been given the sheath may be left in until the medication has worn off sufficiently to allow the puncture site to heal.

What can I expect after the test?

To prevent bleeding, the site will be closed with a special closure device or manual pressure will be held to the insertion site for approximately 10 minutes. A sterile dressing will be placed over the site. Your heart rhythm blood pressure and oxygen saturation and pulses will be monitored frequently during your recovery period. The insertion site will be checked frequently for bleeding and pulses in your feet will be checked for to assess circulation. The recovery period usually takes about 2 hours if a closure device was used. If manual pressure was held you will lie flat up to 4-6 hours. You will be encouraged to drink fluids to prevent dehydration and help flush the dye through your kidneys.

The results of the test will determine what happens next. You may be discharged home and have further intervention done on an outpatient basis or be treated with medical therapy and risk factor modification.

You may experience some soreness and bruising at the insertion site. This is temporary and should resolve within 2 weeks. For any bleeding emergencies call 911 immediately. Call your doctor immediately if your leg becomes pale, cold, painful or numb. Also if you develop a fever or if you experience drainage or swelling at the insertion site.

Specific discharge instructions will be given to you and your family concerning your level of activity and when you may return to work and resume driving.

Is there any thing I need to do to prepare for the test?

  • You will need to make arrangements to have someone drive you home and stay with you overnight. Please inform the cath lab if this is not possible at (717) 316-3551.
  • Do not eat or drink anything after midnight except sips of water for medications in the morning of the procedure.
  • Take your morning cardiac medications including aspirin with a sip of water. Hold diuretics (Lasix, Hydrochlorothiaziside or HCTZ), Metformin (Glucophage, Metformin, Avandament, Fortamet, Glucovance, Actoplus Met, Prandimet, Janumet, Metaglip) and oral hypoglycemic medications, as well as any insulin.
  • Bring all your medications in their original containers with you to the hospital, including the ones you stopped before the procedure. This also includes all over the counter medications and herbal supplements.
  • If you are taking Coumadin your physician will instruct you on the dose changes prior to the procedure. Generally it is held 3 days prior to the procedure.
  • A Cardiovascular nurse will contact you one business day prior to your procedure to give you a time to report to the hospital and review your pre cath instructions. If a nurse does not call by 6pm the night before your procedure, please call 637-3711 and have the operator page the cardiovascular supervisor on-call. The supervisor will call you back and review the instructions at that time.
  • You will report directly to the Cardiovascular Lab on the 2nd floor of the Hospital.
  • Should you have any questions, please call the Cardiovascular Lab at (717) 316-3551. When the department is closed you may leave a message or for more timely needs call (717) 316-3711 and have the cardiovascular supervisor paged.

When will I receive the results of the procedure?

Results will be reviewed immediately after the procedure by the vascular surgeon performing the procedure. The results will be discussed with you and your family while you are still in the recovery area. A copy of the report will be sent to your family physician.

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Carotid Angioplasty and Stenting

What is the purpose of this procedure?

Balloon angioplasty (typically used in combination with a stent) can be used to treat carotid artery stenosis. Your arteries are normally smooth and unobstructed on the inside, but as you age, plaque (made of cholesterol, calcium and fibrous tissue) can build up in the wall of your arteries. This process is called atherosclerosis, or hardening of the arteries. When plaque builds up enough to reduce blood flow through the arteries to the brain, it can cause stroke and paralysis. As an alternative to an endarterctomy procedure, your physician may recommend angioplasty and stenting to treat the blocked arteries. For certain types of blockages, carotid stenting has some advantages when compared to surgery, where an incision is made in the neck and the plaque is cut out of the arteries. Angioplasty and stenting can be performed while you are awake so there is no risk of receiving general anesthesia. Also because this percutaneous procedure does not require a large incision, the recovery period is faster and patients usually spend one night in the hospital and go home the next day. Nevertheless, in some circumstances, an endarterectomy may be a better option. Your vascular surgeon will help you decide what alternative is best for your individual situation.

What can I expect during the procedure?

In the prep/recovery area, electrodes (small round pads) and EKG (electrocardiogram) leads (wires) will be applied and these leads will be connected to an electrocardiogram machine that continuously monitors your heart rhythm. A blood pressure cuff and a finger probe will be applied to monitor your blood pressure and oxygen saturation during the procedure. You will be given sedation in your IV for comfort but will remain awake during the procedure. Once in the cath lab, you will lie on a narrow table beneath x-ray cameras. The temperature in the catheterization lab is kept cool so the equipment does not overheat. Your groin will be prepped and you will be covered with a drape from chin to toe.

The physician will numb the groin area with a medication, which may cause a burning sensation. An small plastic a tube will be placed into the left or right groin femoral artery. A guidewire and a catheter are gently inserted through the sheath then threaded through the arteries to the desired location while the doctor watches on the imaging monitor. Blood vessels have no pain nerves so you won’t feel them moving through the artery. Dye will be injected through the catheter and x-ray images will be taken. You may feel a warm sensation when the dye circulates through your body. Several images (angiograms) are taken of each artery in the brain. The images will show the amount of narrowing in the artery and the exact location. You may be asked to “take a deep breath and hold it”. It is very important to hold as still as possible so the images are not distorted.

The physician then inserts a balloon catheter over the guidewire, through the catheter. The balloon catheter carries a deflated, folded balloon on its tip. It is guided to the narrowed segment of your artery. The balloon is inflated several times until the plaque is flattened against the walls of the artery. This process usually takes a few minutes. Your artery will stretch and the blood flow through the artery is paused when the balloon is inflated, moving the difficult plaque to the vessel walls. This may cause pain in your neck but should go away when the balloon is deflated and normal blood flow resumes.

After an angioplasty, there is a risk of re-narrowing or re-stenosis of the narrowed artery. It can happen soon after the procedure or months to years later. Sometimes the physician will need to keep the artery open with a tiny mesh tube called a stent. It looks like a tiny spring and comes in all sizes. The angioplasty balloon is removed and a stent balloon is inserted through the catheter. When the stent balloon is at the location of the blockage in the artery, the balloon is inflated inside the stent and this expands the stent. The balloon is then deflated and the catheter removed. The stent stays in place inside the artery wall. The artery wall will grow over the stent and prevent it from moving. Because blood-thinning medication has been given during the procedure, the sheath may be left in the groin site until the medication has worn off sufficiently to allow the sheath to be removed and the puncture site to heal.

What can I expect after the test?

To prevent bleeding, the groin site may be closed with a special closure device or manual pressure will be held to the insertion site for approximately 10 minutes. A sterile dressing will be placed over the site. Your heart rhythm blood pressure and oxygen saturation and pulses will be monitored frequently during your recovery period. The insertion site will be checked frequently for bleeding and pulses in your feet will be checked to assess circulation. The recovery period usually takes about 2 hours, if a closure device was used. If manual pressure was held you will lie flat up to 4-6 hours. You will be encouraged to drink fluids to prevent dehydration and help flush the dye through your kidneys.

You may experience some soreness and bruising at the insertion site. This is temporary and should resolve within 2 weeks. For any bleeding emergencies call 9-1-1 immediately. Call your doctor immediately if your leg becomes pale, cold, painful or numb. Also if you develop a fever or if you experience drainage or swelling at the insertion site. Specific discharge instructions will be given to you and your family concerning your level of activity and when you may return to work and resume driving.

Is there any thing I need to do to prepare for the test?

  • You will need to make arrangements to have someone drive you home the day of discharge.
  • Do not eat or drink anything after midnight except sips of water for medications in the morning of the procedure.
  • Take your morning cardiac medications including aspirin with a sip of water. Hold diuretics (Lasix, Hydrochlorothiaziside or HCTZ), Metformin (Glucophage, Metformin, Avandament, Fortamet, Glucovance, Actoplus Met, Prandimet, Janumet, Metaglip) and oral hypoglycemic medications, as well as any insulin.
  • Bring all your medications in their original containers with you to the hospital, including the ones you stopped before the procedure. This also includes all over the counter medications and herbal supplements.
  • If you are taking Coumadin (Warfarin) your physician will instruct you on the dose changes prior to the procedure. Generally it is held 3 days prior to the procedure.
  • A Cardiovascular nurse will contact you one business day prior to your procedure to give you a time to report to the hospital and review your pre cath instructions. If a nurse does not call by 6pm the night before your procedure, please call 637-3711 and have the operator page the cardiovascular supervisor on-call. The supervisor will call you back and review the instructions at that time.
  • You will report directly to the Cardiovascular Lab on the 2nd floor of the Hospital.
  • Should you have any questions, please call the Cardiovascular Lab at (717) 316-3551. When the department is closed you may leave a message or for more timely needs call (717) 316-3711 and have the cardiovascular supervisor paged.

When will I receive the results of the procedure?

Results will be reviewed immediately after the procedure by the physician performing the procedure. The results will be discussed with you and your family while you are still in the recovery area. A copy of the report will be sent to your family physician.

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