Post-Angiography Care

The clinician manages complex post-angiography complications independently, prescribes antithrombotic regimens, and implements quality improvement protocols. Advanced complication management includes: large pseudoaneurysms (above 3 cm) with expansion requiring interventional radiology consultation for thrombin injection or covered stent placement; retroperitoneal hemorrhage requiring CT angiography, transfusion, reversal of anticoagulation, and possible endovascular embolization; cholesterol embolization syndrome presenting days to weeks post-catheterization with livedo reticularis, blue toe syndrome, renal failure, and eosinophilia (no specific treatment beyond supportive care and statins). The clinician prescribes CIN prevention protocols stratified by patient risk: minimal risk (eGFR above 60, low contrast volume) requires only oral hydration; moderate risk (eGFR 30-60, diabetes, moderate contrast) requires IV saline hydration protocol; high risk (eGFR below 30, emergent procedure, high contrast) requires aggressive IV hydration, minimize contrast volume, consider staged procedures, and prepare for potential RRT. The clinician also implements same-day discharge protocols for low-risk diagnostic catheterization patients: radial approach, no PCI, stable vital signs at 2 hours, adequate hemostasis, eGFR above 60, reliable social support and transportation, ability to return if complications develop.