Cerebral Angiography is a medical procedure which uses a dye (contrast material) and X-rays to visualize the arteries and veins in the neck and brain.
When is cerebral angiography performed?
Cerebral Angiography is generally recommended by the doctor to evaluate patients with stroke, brain bleed, aneurysms, vascular malformations and brain tumors.
Who performs the Cerebral Angiography?
A specialist trained in neuro interventions can perform cerebral angiography. The doctor can be a neurosurgeon, neuro-radiologist or a neurologist.
How does someone prepare for a cerebral angiography?
Before scheduling cerebral angiography, the doctor will check the patient’s kidney function and order other blood tests.
Please inform the doctor about:
- The patient’s allergies (specific allergy to shellfish and iodine)
- History of bleeding gums or easy bruising in the past
- The patient’s medications (specifically Metformin for diabetes mellitus
- Whether she is pregnant or not
- The patient may be asked to not eat and drink anything for about 8-12 hours prior to the procedure
How is the Cerebral Angiography performed?
- The patient will be asked to lie on an X-ray table.
- The patient’s head may be strapped using a tape to keep it still.
- The patient may be given intravenous medications for pain and to put him to light sleep.
- A numbing medication (local anesthesia) is given around the artery in the groin (femoral artery). The patient may have a transient stinging or burning sensation when the medication is injected in the groin.
- A long catheter (a catheter is a long slender tube) is inserted through the artery in the groin and passed all the way up to the neck with the help of X-rays
- Contrast dye is injected into the various arteries in the neck that carry blood to the brain and X-ray pictures taken to visualize the arteries and the veins and the blood flow pattern.
- A diagnostic Cerebral Angiogram usually lasts about 30-45 minutes depending upon the specific arteries and veins that are being examined.
- While the dye is being injected, the patient may feel a warm flushing sensation. He may also experience a metallic taste in the mouth for a few minutes.
- After the Cerebral Angiogram, the doctor removes the tube from the groin and holds pressure over the artery in the groin to allow blood to clot and seal the hole in the artery.
- Alternatively, the doctor may use a closure device to seal the hole in the artery.
How long does anyone have to stay in the hospital after Cerebral Angiography?
A diagnostic cerebral Angiography is usually performed as an outpatient procedure. The patient will have to lay flat in the bed for about 3-6 hours after which he may be discharged.
What precautions should anyone take after going home from Cerebral Angiography?
- It is recommended not to drive or do any strenuous work for 1-2 days after the procedure.
- Do not exercise.
- The patient may walk around in the house.
- The patient may have some soreness in the groin for a couple of days.
- The patient may resume normal daily activity from the next day or the day after.
- The patient may take over-the-counter pain medications if needed.
- If the patient is diabetic and takes Metformin, do not take the medication for 24-48 hours following the procedure.
- Immediately call the doctor's office if the patient experiences:
- severe itching all over the body
- rash over the groin or anywhere in the body
- swelling in the groin
- bleeding from the groin
- slurred speech
- the weakness of an arm or leg
What are the various risks related to Cerebral Angiography?
- There is a small risk of allergy to the contrast dye. If the patient is having a history of allergy to the dye, doctor may ask the patient to take some medications prior to the procedure to prevent any allergic reaction
- There is a small risk of bleeding from the puncture site in the groin (1%-2%). Alternatively, the bleeding may be under the skin forming a 'pseudo-aneurysm'. A swelling may be seen in the puncture site in the groin.
- In about 0.5%-1% of the patients, a clot from within the catheter or a cholesterol plaque from one of the arteries in the neck may be dislodged and block an artery supplying the brain leading to stroke. With the advent of newer techniques, the incidence of a major or significant stroke following diagnostic Cerebral Angiography in experienced hands is very low.