Cerebral Angiogram

What is a Cerebral Angiogram? A cerebral angiogram is an exam that shows the blood vessels in the brain and neck in fine detail. It helps your doctor find any problems in the vessels that might affect blood flow. To get good pictures of these vessels, a doctor will inject a contrast medium (sometimes called “dye”) into the arteries to be studied.  These detailed pictures of your blood vessels will help your doctors plan your treatment.

 

What is the Purpose of this Exam?

There are many reasons for this exam.  Each patient’s exam is slightly different depending on his or her specific problem. 

A cerebral angiogram can:

• Look for “hardening of the arteries,” which makes the inside of a blood vessel smaller and often causes stroke.
• Show the location of blood vessels in and around a tumor.  This is very important if surgery is being considered.
• Identify a bulging, bubble-shaped weakness on a blood vessel (called an aneurysm) or an abnormal clump of blood vessels (called an A-V malformation).
• Look for the cause of a stroke or a TIA (“mini stroke”).

 

How Should I Prepare for this Exam?

Tell your doctor if:

• You have any allergies.
• You or members of your family have had problems with anesthetics.
• You have had a reaction to contrast dye or iodine.
• You have any blood disorder.
• You have had any surgeries.
• You are pregnant or might be pregnant.
• You are breastfeeding.

Also tell your doctor about all the medicines you take. Be sure to include vitamins, herbs, eye drops, creams, and over-the-counter medicines.

We will let you know what medicines to stop taking for the exam.  This is especially important if you take diabetes medicines or blood thinners.  If you take aspirin or ibuprofen, ask your doctor if you should stop taking them.

You will receive sedation (medicine to help you relax during your exam).  Arrange for someone to drive you home.  Sedation will make you feel sleepy and wobbly for several hours.  You will not be able to drive yourself home.

Do not eat any food 6 hours before you arrive for your angiogram.  This includes gum, candy, protein drinks, and instant breakfasts.

You may drink small amounts of clear liquids up to 2 hours before the time you are to arrive at the hospital.  Clear liquids include water, soda, coffee and tea without cream or milk, and juices without pulp.  You will receive liquids through an IV in a vein in your arm (usually the left).

Your nurses will not know the exact time of your exam.  Because each exam is tailored to the needs of the patient, we cannot predict a precise schedule.  Most exams are in the morning or early afternoon.

We will ask you to put on a hospital gown. You will need to use the bathroom to empty your bladder. We may wash and shave your groin, the area above the hip.  You will need to remove your dentures, contact lenses or glasses, earrings, necklaces, wristwatch, and any hair items.

 

You may receive medicine to help you relax.  If you do, stay in your bed in order to stay safe.

 

What Happens During the Exam?

The angiogram takes place in the Special Procedures or Interventional Radiology suite. You will lie on an x-ray bed with a C-shaped machine around you.  You might have a strap on your head to help you hold your head still.

You will be awake during the exam, but you may have received medicine to help you relax.  Nurses will watch your heart rate and other vital signs through the whole exam.

Your arm or leg will be washed with an antiseptic, draped, and numbed with an anesthetic.  The doctor will insert a long, thin, flexible tube called a catheter into the large artery in your groin or in your arm near the wrist. 

While the catheter is being inserted and moved, you may feel pressure in your groin or arm.  Moving the catheter in your arteries is painless.

The doctor will inject small amounts of contrast medium (or “dye”) through the catheter to help track the catheter as it moves.  You may feel small flashes of warmth in your arms, neck, and head. 

Some patients get a metallic taste in their mouth or see spots or flashes of light.  This is normal.  Do not be alarmed if this happens to you.

When the catheter is in place, more contrast medium is injected, and x-ray pictures are taken.  It is important not to move your head during this process.  It is normal to hear beeping noises during the procedure. The doctor may move the catheter several times and take x-ray pictures of several blood vessels in different views. 

A cerebral angiogram generally takes from one to two hours.  Your breathing, pulse, blood pressure, level of consciousness, and other brain functions will be checked often during the exam. 

When the angiogram is done, the doctor will remove the catheter.  We will apply pressure or a collagen seal until the puncture site is no longer bleeding.  To lessen the chance of bleeding, you will need to stay in bed. 

Lie flat and do not bend your leg or arm for at least 2 to 6 hours after the exam.  It depends on how your doctor closes your incision.  Before you leave the hospital, nurses will tell you how to care for the puncture site.

It is important to drink plenty of fluids after the test to get rid of the contrast medium (dye).  The dye will leave your body in your urine.  If you need to empty your bladder during the exam, you will use a bedpan, urinal or urinary catheter.

Plan to stay at the hospital for 8 to 10 hours.  Your family can visit you in your hospital room after your procedure.  You will be able to eat and drink 1 to 2 hours after the exam. 

 

After your exam:

• Stay away from activities that make you tired
• Do not lift heavy weights
• Try not to cough too much
• Try not to sneeze
• Do not force your stools

 

What Complications can Occur?

A common problem after an angiogram is a bruise around the puncture site.  This occurs most often in older patients with high blood pressure.  Usually it goes away in a few days or weeks.

Once in a while the “dye” can cause a change in blood pressure or an allergic reaction.  In that case, you will receive drugs to reduce the symptoms. 

A small number of patients have a brief change in feeling, muscle strength, speech or vision during or shortly after a cerebral angiogram.  The change may last from a few seconds to a few minutes.  This may be a sign of a stroke.  Please tell your doctor or nurse if you have these symptoms.

Complications of cerebral angiogram are rare, less than one in one hundred, including the highest risk cases.  The catheter can block the artery when it is inserted, or an infection can occur.  Other risks include blood clot, bleeding, stroke, or kidney injury. These are very rare.

Your doctors and nurses will be happy to answer any questions you may have.

 

 

Call your doctor right away if you have:

• Bleeding that does not stop after you put firm pressure on the incision for 10 minutes.
• More swelling of your groin or leg.
• Pain in your groin or down your leg that is not normal.
• Signs of infection such as:
• • redness
  • warmth
  • drainage, other than a little blood on the bandage
  • your incision is not healing well
  • fever or chills
• A severe headache.
• Change in your ability to think clearly.