Plaque can build up in your arteries, especially those in your neck, narrowing the blood vessels and causing problems due to inadequate blood flow to your brain. Angiography helps us diagnose artery disease and identify ways to fix those blockages. In fact, cerebral angiography is the foundation of all neurovascular interventional procedures.
Before determining what is wrong with the blood vessels in the neck or brain, we must create a highly accurate picture of these blood vessels and the abnormality. While there are other minimally invasive techniques, such as CT angiography and MR angiography, that can provide information, by far the most accurate way of evaluating these blood vessels, is the angiogram. Cerebral angiography can also diagnose aneurysms in the brain, arteriovenous malformations, bleeding vessels, or bleeding tumors, so that we can stop the bleeding by plugging the responsible artery or repairing the aneurysm.
Unless you are admitted to the hospital, you will typically meet with your doctor prior to having an angiogram so he or she can answer any questions you may have before the procedure. It’s important to tell your doctor (or the physician’s assistant) if you are taking any blood thinning agents like Coumadin, Xarelto, Pradaxa, Elequis, aspirin, or others. Your doctor will also ask you whether you have kidney disease or other conditions that may be important.
What happens during an angiogram?
You will have already discussed the treatment options with the physician doing the procedure.
Prior to your procedure, we will take you to a preparation area where our nurses will start an IV in your arm and give you any medication that may be required prior to your procedure. We may give you medicines to protect your kidneys, antibiotics to help prevent infection, and anti-nausea medications.
When it’s time to begin, we’ll take you to a special room that is similar to an operating room. We often use conscious sedation, or moderate anesthesia, during the procedure, so you’ll remain slightly awake throughout the procedure. We will monitor your pulse, blood pressure, and your breathing throughout the procedure.
During the procedure, you’ll lie on your back on a table and we’ll clean the area where the catheter (a thin, hollow tube) will enter your body using a special solution to minimize infection. We’ll place sterile drapes over your body and the neurointerventionalist will apply a local anesthetic so you don’t feel any pain.
Your neurointerventionalist will make a small incision in your groin/upper thigh or arm to insert the catheter. Then, we’ll use an iodine-based contrast material (dye) to make the blood vessels stand out as we take special x-ray pictures or look at a special TV monitor (fluoroscopy). We can also make three-dimensional images to help us better see an aneurysm. At the end of the procedure, your neurointerventionalist will withdraw the catheter and either apply pressure or place a special device in the blood vessel to stop the blood from leaking out. Finally, we’ll put a bandage over the incision.
After your procedure, your neurointerventionalist will review the results of your cerebral angiogram with you and discuss next steps.