Cerebral Angiogram

Cerebral angiography is a procedure that doctors use to image blood vessels in the brain, allowing your doctor to determine whether the vessels are diseased, narrowed, enlarged or blocked altogether. This procedure can help diagnose blockages, aneurysms and other abnormalities of the blood vessels. With this information, your care team can recommend a course of treatment for you.

The angiogram is a minimally invasive procedure. A catheter (long, thin, flexible plastic tube) is placed into your leg and is guided through the blood vessels of the body to reach the neck and head. An x-ray dye is injected to highlight the vessels simultaneously while images are taken from several angles. The procedure is done in the angiography suite with a special team of physicians, physician assistants, nurses, and technologists.

Common reasons to do a cerebral angiogram include the following:

First, the skin at the access site (usually the right groin) will be cleaned and shaved. Then a small dose of pain medication is given through the IV line.

The skin where the catheter will be placed will be numbed beforehand. This may sting briefly but usually makes the rest of the procedure pain free. The neuroradiologist threads the catheter (long, flexible, plastic tube) through the arterial system to the desired location and injects the contrast (X-ray dye). During the procedure, you will not feel the catheter in the artery, but when the contract material is injected, you may have a sense of warmth. X-rays are taken once the contrast is injected.

After the angiogram is completed, the catheter is removed and the puncture site closed. The incision site can be closed either by manual compression or by using a special closure device.

You will have to lie flat for two to six hours after angiography, depending on the reason for the test, the catheter size, and the type of device used to close up the artery. During this time, you should inform the nurse if you notice any bleeding, bruising, swelling or pain at the site where the catheter entered the skin. The entire procedure may take from one hour to several hours.

Cerebral angiography is a very detailed, clear, and accurate picture of the blood vessels in the brain. This is especially helpful when a surgical procedure or a neuroradiologic intervention is being considered.

By selecting the arteries using a catheter, it allows physicians to assess only the blood vessels.

Unlike computed tomography (CT) or magnetic resonance imaging (MRI) angiography, the use of a catheter makes it possible to combine diagnosis and treatment into one procedure. An example is finding an area of severe arterial narrowing, followed by angiography and placement of a stent.

The degree of detail displayed by catheter angiography cannot be obtained with any other noninvasive procedure.

Some patients can have an unusual allergic reaction to the contrast. Reactions range from mild skin irritation, itching, a drop in blood pressure, difficulty breathing, and loss of consciousness or death. These reactions only happen in approximately 1/50,000 to 1/150,000 people. You should tell your doctor of a previous allergy prior to this test.

There is a very tiny risk that blood will form a clot around the tip of the catheter, blocking the artery and causing a stroke. The chance of developing a permanent stroke (weakness, numbness or paralysis) as the result of a cerebral angiogram is approximately 0.5%.

If you have diabetes or kidney disease, the kidneys could be injured when contrast material is eliminated through the urine.

Very rarely, the catheter can injure the vessel wall.

Very rarely, the blood vessel the catheter was inserted into becomes blocked and prevents blood from going to your lower leg and foot. This requires an emergency operation to reopen the blocked blood vessel.

Delayed bleeding at the site of catheter insertion is very uncommon but it is the major reason that you are observed for 4-6 hours after your test is completed.

With interventional radiology procedures using x-rays, the level of risk depends on the type of procedure because some use very little radiation, while complex procedures use more.

Woman should always inform their doctor if there is any possibility that they are pregnant.