Understanding Cerebral Angiogram

What is a cerebral angiogram?

A cerebral angiogram is a diagnostic test that allows your doctor to see the veins and arteries in your brain, and assess how well blood is flowing through them. This test is also known by other names, including cerebral angiography and cerebral arteriogram.

During the procedure, a doctor guides a hollow, flexible tube called a catheter through your main arteries until it reaches your neck. The doctor will inject a special dye through the catheter and, using X-ray imaging, will watch the dye travel through the blood vessels in your brain.

Cerebral angiograms help doctors confirm whether there is a problem with one or more of the blood vessels in your brain, including:

• a bulging or ruptured artery (aneurysm)
• narrowed or blocked arteries (atherosclerosis)
• tangled veins and arteries that are not properly connected (arteriovenous malformation)
• an inflamed blood vessel (vasculitis)

How to prepare for your cerebral angiogram

The following general guidelines apply to most people who are preparing for their cerebral angiogram. Your doctor or another clinician from Lyerly Neurosurgery may give you additional instructions.

• The night before your procedure, you should not eat or drink anything after midnight.
• The morning of your procedure, do not take any prescription or over-the-counter medications that can increase bleeding risk. These include blood thinners and nonsteroidal anti-inflammatory drugs (such as aspirin, ibuprofen and naproxen). However, if you are taking Plavix or aspirin under Dr. Hanel's or Dr. Sauvageau's direction, please continue taking your daily dose unless a member of our team tells you otherwise.
• If you use other daily prescription medications, you may be able to take them as usual the morning of your procedure — your doctor will let you know what is safe to use.
• Unless instructed otherwise, your craniotomy and subsequent brain surgery will take place at Baptist Medical Center Jacksonville. Please check in at the registration area located on the first floor of the Wayne and Delores Barr Weaver Tower. You will be given detailed instructions on what time to arrive and where to park.
• Bring your prescription or over-the-counter medications with you to the hospital, in their original containers.

What to expect during your cerebral angiogram

On average, a cerebral angiogram takes one to three hours to complete.

When it's time to begin, a member of the interventional team will help you lie down on your back on a special adjustable table called an X-ray table. For your safety, and to keep your head still during the exam, the interventional team member will place straps across your head, chest and legs. He or she will also place a needle in your arm, so you can receive fluids and a mild sedative intravenously.

When it's time to place the catheter in your artery, a member of the health care team will wash, disinfect and numb the area of your body (typically the groin) where the catheter will be inserted. He or she also may need to shave away a small amount of hair.

Once the catheter has been placed, a doctor will carefully guide it up through the main blood vessels in your abdomen, chest and neck. You will not be able to feel the catheter moving through your arteries.

You'll receive an injection of contrast dye once the catheter has reached its final destination. You may feel a temporary warm or flushing sensation as the dye enters your blood stream.

Using X-ray technology, the doctor will monitor the dye as it moves through the blood vessels in your brain. He or she will take a series of pictures to document abnormal blood flow, structural defects, or other problems that may show up during the exam.

Upon completion of your cerebral angiogram, the doctor will remove the catheter and then bandage the insertion site. From there, you will be taken to a recovery area for observation.

What to expect after your cerebral angiogram

During the first couple of hours following your procedure, you will need to remain lying down. Members of your health care team will monitor your heart rate and other vital signs, and make sure you are not bleeding from the catheter insertion site.

Your doctor will let you know whether you can be discharged from the hospital the same day as your procedure, or if you will need to stay overnight. He will also talk to you and your family about the results of your angiogram.

Drinking plenty of fluid after your exam will help flush the contrast dye from your body.

It is normal for your catheter insertion site to remain tender or bruised for several days. During this time you should avoid heavy lifting and other strenuous activities.

Once you are home, pay attention to any unusual symptoms. Call our office at 904.861.0316 if you experience any of the following:

• excessive bleeding, swelling or new bruising at the insertion site
• worsening pain or discomfort at the insertion site
• drainage from the insertion site
• fever
• sudden shortness of breath
• color or temperature changes in any limb that was used during the procedure

Are there any risks I should be aware of?

In general, a cerebral angiogram is a safe procedure and few people experience complications. However, as with any medical procedure, there are rare but serious risks associated with cerebral angiography. These include:

• allergic reaction to the contrast dye (please let your doctor know if you are allergic to iodine)
• prolonged exposure to X-ray radiation
• infection
• excessive bleeding
• a torn or damaged blood vessel
• a blood clot that forms around the tip of the catheter, then remains in the blood vessel
• stroke, which can occur if the catheter dislodges plaque from an artery wall, and the plaque becomes lodged in a blood vessel

If you have any questions or concerns about the safety of this procedure, please do not hesitate to discuss them with your doctor.