What is a cerebral angiogram?
A cerebral angiogram is an x-ray examination of the blood vessels (arteries and veins) of the brain performed by a physician with neuroradiology training. During an angiogram, the patient is generally awake but sedated, having received IV medications to help relax. A nurse trained in conscious sedation monitors the patient during the procedure.
Typically the femoral artery, the large artery in the groin, is accessed through a small nick in the skin. A thin tube or catheter is then guided under the guidance of an x-ray machine into the arteries in the neck leading to the brain. X-ray dye is injected through the catheter while taking x-rays of the brain, making the blood vessels visible.
In most cases, several injections are needed to complete the examination. Once the angiogram is complete, the catheter is removed. To prevent the artery from bleeding, pressure is applied to the groin site for about 15 minutes, or a vascular closure device may be used. The procedure usually takes 1 to 2 hours. Afterwards, several hours of bedrest may be required depending on how the vessel was closed.
Why an angiogram?
Cerebral angiography is the most definitive way to view the blood vessels of the brain. In addition to providing high resolution images, an angiogram also provides information about the blood flow with each heartbeat.
Brain aneurysms, vascular malformations and vessel blockages are among the abnormalities that can be accurately detected using an angiogram. Angiograms are also used for treatment planning or as part of the endovascular treatment of some of these conditions.
What are the benefits and risks of an angiogram?
Benefits
Cerebral angiography is the gold standard for diagnosing abnormalities of the blood vessels of the brain. Results from an angiogram are more accurate than other forms of imaging including CT, MRI or US in making vascular diagnoses. Unlike a CT or MRI angiogram, a catheter angiogram makes it possible to combine diagnosis and treatment in a single procedure in certain cases.
Risks
All medical procedures carry some risks. The main risk of cerebral angiography is the risk of stroke, which can come from clot formation on the catheter, clot dislodgment or from catheter-induced damage to blood vessel walls. Overall, the risk of stroke during diagnostic angiography at high volume centers is much less than 1%. More common but less severe complications include bleeding, bruising or infection at the groin site and allergic reaction to x-ray dye. There is also some exposure to radiation. All efforts are made to ensure these risks are minimized. Some risks may be patient-specific and would be discussed prior to performing the angiogram.
How do you prepare for an angiogram?
Prior to having an angiogram, your doctor needs to know whether you are
You will be asked not to eat or drink for several hours prior to the angiogram. You may also be asked to hold specific medications. Several blood tests may be performed prior to the procedure.
How do you recover from an angiogram?
Since angiograms are usually performed under sedation, you will be asked not to drive or operate machinery for the next day.
It is also important not to perform any heavy lifting for about a week following the procedure to allow the groin site to heal, and not to submerge the site under water (i.e. no baths or swimming; showers are okay) during this time.
A cerebral angiogram is an x-ray examination of the blood vessels (arteries and veins) of the brain performed by a physician with neuroradiology training. During an angiogram, the patient is generally awake but sedated, having received IV medications to help relax. A nurse trained in conscious sedation monitors the patient during the procedure.
Typically the femoral artery, the large artery in the groin, is accessed through a small nick in the skin. A thin tube or catheter is then guided under the guidance of an x-ray machine into the arteries in the neck leading to the brain. X-ray dye is injected through the catheter while taking x-rays of the brain, making the blood vessels visible.
In most cases, several injections are needed to complete the examination. Once the angiogram is complete, the catheter is removed. To prevent the artery from bleeding, pressure is applied to the groin site for about 15 minutes, or a vascular closure device may be used. The procedure usually takes 1 to 2 hours. Afterwards, several hours of bedrest may be required depending on how the vessel was closed.
Why an angiogram?
Cerebral angiography is the most definitive way to view the blood vessels of the brain. In addition to providing high resolution images, an angiogram also provides information about the blood flow with each heartbeat.
Brain aneurysms, vascular malformations and vessel blockages are among the abnormalities that can be accurately detected using an angiogram. Angiograms are also used for treatment planning or as part of the endovascular treatment of some of these conditions.
What are the benefits and risks of an angiogram?
Benefits
Cerebral angiography is the gold standard for diagnosing abnormalities of the blood vessels of the brain. Results from an angiogram are more accurate than other forms of imaging including CT, MRI or US in making vascular diagnoses. Unlike a CT or MRI angiogram, a catheter angiogram makes it possible to combine diagnosis and treatment in a single procedure in certain cases.
Risks
All medical procedures carry some risks. The main risk of cerebral angiography is the risk of stroke, which can come from clot formation on the catheter, clot dislodgment or from catheter-induced damage to blood vessel walls. Overall, the risk of stroke during diagnostic angiography at high volume centers is much less than 1%. More common but less severe complications include bleeding, bruising or infection at the groin site and allergic reaction to x-ray dye. There is also some exposure to radiation. All efforts are made to ensure these risks are minimized. Some risks may be patient-specific and would be discussed prior to performing the angiogram.
How do you prepare for an angiogram?
Prior to having an angiogram, your doctor needs to know whether you are
- Pregnant or breast feeding
- Have any allergies, especially to iodine dye
- Have bleeding problems or are on any blood thinners
- Have diabetes, especially if you take metformin
- Have any kidney disease
You will be asked not to eat or drink for several hours prior to the angiogram. You may also be asked to hold specific medications. Several blood tests may be performed prior to the procedure.
How do you recover from an angiogram?
Since angiograms are usually performed under sedation, you will be asked not to drive or operate machinery for the next day.
It is also important not to perform any heavy lifting for about a week following the procedure to allow the groin site to heal, and not to submerge the site under water (i.e. no baths or swimming; showers are okay) during this time.
