The Cath Lab at Town Hospital
Diagnostic and therapeutic catheterisation — open 24 hours
The cath lab is open 24 hours a day, seven days a week
If a doctor has told you that you need a catheter procedure, it is normal to feel anxious. The word sounds bigger than what actually happens: a thin, flexible tube passes through a small opening at the wrist or the top of the thigh, reaches the arteries, and shows what is inside them clearly on a screen. The cath lab at Town Hospital is equipped with a Philips bi-plane system, which gives the ability to care for the circulation of the brain, the heart and the limbs, and the unit runs 24 hours a day.
Before the procedure starts, the team explains the steps one by one and tells you what you will feel at each stage. You are usually awake. Local anaesthetic is given at the entry point only, so you feel a sting and then mild pressure, and you do not usually feel the catheter moving inside the arteries, though during some treatment steps you may feel pressure or tightness in the chest — tell the team straight away. When the contrast dye is injected you may feel a short wave of warmth pass through your body and then fade; that is expected. Your heartbeat and blood pressure are watched on a monitor the whole time, and you can tell the team at any moment if something bothers you. Afterwards the entry point is closed with a pressure dressing, you stay under observation for a few hours, and then the doctor explains what the images showed and what happens next.
What catheterisation is, and the difference between diagnostic and therapeutic
Catheterisation is not open surgery. The doctor passes a thin, flexible tube through a small opening at the wrist or the top of the thigh and guides it to the artery in question, following it on live X-ray imaging. Contrast dye is then injected to show the flow of blood inside the artery, so the doctor can see precisely where a narrowing or a blockage is and how far it extends.
A diagnostic catheterisation is for looking only: an accurate map of the arteries that ends in a report and a treatment decision. A therapeutic catheterisation deals with the problem through the same route, opening the narrowed segment and supporting it where needed. In some cases the procedure begins as diagnostic and continues as therapeutic in the same session if the doctor judges that this is in your interest, and that possibility is discussed with you before anything starts. Catheterisation is a well-established procedure with well-understood steps, but like any medical procedure it carries possible complications, which your doctor explains before taking your consent.
What a bi-plane lab means, in plain language
A single-plane cath lab has one imaging arm that captures one angle at a time; if the doctor needs another angle, the run is repeated and the contrast dye is injected again. The bi-plane system in the cath lab at Town Hospital has two arms that image simultaneously from two different directions.
What does that mean for you? Usually fewer contrast injections to reach the same information, less time inside the room, and a clearer view of vessels that are small or tangled together — which matters especially in the vessels of the brain.
One unit serving the heart, the brain and the limbs
The unit is not for the heart alone. The system gives the ability to care for the circulation of the heart, the brain and the limbs, and it is used by the cardiology team and by the vascular surgery and interventional radiology team, each within its own field.
On the cardiac side, the cardiology department manages angina and clots, valve disease, blood pressure and heart failure, and diagnostic or therapeutic catheterisation is used when it is the right step for the case. That is follow-up for stable cases; severe chest pain or symptoms that look like a heart attack belong in emergency straight away, not in an appointment. If a case needs more than a minimally invasive approach, open-heart surgery, coronary artery grafting and valve repair or replacement are available inside the same hospital in the cardiothoracic surgery department, so you are not sent elsewhere.
Peripheral work: arteries, veins and the diabetic foot
The vascular surgery department manages narrowed and blocked arteries, venous clots, varicose veins and the diabetic foot, and peripheral arterial catheterisation is carried out in the same unit. The complaint patients arrive with is usually simple to describe: leg pain on walking that settles when they stand still, a cold or pale foot, or a wound that will not heal.
In people with diabetes in particular, checking how well blood is reaching the foot is a basic step, because a wound that is not receiving enough blood is hard to heal no matter how well it is dressed. If, however, there is sudden severe leg pain with pallor and coldness, or sudden swelling of the leg with shortness of breath, that is an emergency: go straight to the emergency department and do not wait for an appointment.
Before the procedure and after it
Your doctor will usually ask for tests beforehand, among them a blood count and kidney function, and may ask for imaging. The laboratory and the radiology department are in the same building and both run 24 hours a day, so tests and scans can be done in one visit, and you can view your results securely through the My Results page (/my-results/) — the link is yours alone, so do not share it with anyone. Tell your doctor about everything you are taking, especially blood-thinning medication and diabetes medication, and follow the fasting instructions exactly as you are given them.
After the procedure the entry point is closed with a pressure dressing, and you may be asked to keep the limb still for a period if the entry was at the top of the thigh. Drink water, as much as your doctor allows, to help clear the contrast dye. If you notice bleeding, swelling or spreading redness at the entry point, or a rise in temperature, come back to the hospital without delay. Follow-up after that is in the outpatient clinics, which are open from 10:00 to 22:00.
The unit runs 24/7 — and when to go straight to emergency
A heart attack does not wait for morning. The cath lab runs 24 hours a day and the emergency department is open 24 hours as well, because in a heart attack or a sudden arterial blockage, time is the single biggest factor in how much heart muscle — or how much of a limb — can be saved.
Go straight to the emergency department — do not book an appointment and wait — if you have: severe chest pain or pressure lasting more than a few minutes, or spreading to the arm, jaw or back, or coming with a cold sweat, shortness of breath or nausea; sudden weakness or numbness in the face or on one side of the body, or sudden difficulty speaking or seeing; sudden severe leg pain with coldness and pallor; or sudden swelling of the leg with shortness of breath. In these situations, do not drive yourself.
Frequently Asked Questions
Is catheterisation surgery, or just a scan?
Catheterisation is a procedure done through a small opening at the wrist or the top of the thigh; it is not open surgery. There are two kinds: diagnostic, which is for seeing the arteries and identifying where a narrowing or blockage is and how far it extends, and therapeutic, which deals with the narrowing itself through the same route. Your doctor decides which one your case needs, and a procedure may begin as diagnostic and continue as therapeutic in the same session if the case calls for it.
Will it hurt while I am in there?
Local anaesthetic is given at the entry point, so you feel a sting and then mild pressure. You do not feel the catheter moving inside the arteries. You may feel a short wave of warmth when the contrast dye is injected, which is expected and passes quickly. You are usually awake, the team explains each step before it begins, and you can tell them at any moment if something bothers you.
Is the cath lab open 24 hours?
Yes — the unit runs 24 hours a day, and the emergency department is open 24 hours as well. If you have severe chest pain, or symptoms that look like a heart attack, do not wait for a clinic appointment: go straight to the emergency department, because speed is what protects the heart muscle.
I have diabetes and a wound on my foot that will not heal — is that related to catheterisation?
It may well be. Poor blood supply to the foot is a common reason wounds are slow to heal in people with diabetes, so assessment starts by checking the blood flow in the arteries of the limb, and peripheral arterial catheterisation may be part of the plan if the vascular surgeon decides so. If the wound comes with sudden severe pain, a cold or pale foot, or a raised temperature, the right thing to do is to go to the emergency department immediately.
Where do I do the tests before the procedure, and how do I get the results?
The laboratory and the radiology department are in the same building and both run 24 hours a day, so the tests and scans needed before the procedure can be done in a single visit. You can then view the results securely through the My Results page on the hospital website (/my-results/). Results are confidential and belong to you alone, and the private link to them should not be shared with anyone.