Cerebral angiogram

An angiogram of the head or neck is done to:

• Look for blockage or narrowing of the arteries in the neck that carry blood to the brain. The test may help your doctor decide if a procedure is needed to open a narrowed or blocked artery to increase blood flow. Blood flow to the brain that is slowed or stopped increases the chance of having a stroke or a transient ischemic attack (TIA).
• Study symptoms that might mean problems with the blood flow to the brain. Symptoms may include severe headaches, memory loss, slurred speech, dizziness, blurred or double vision, weakness or numbness, or loss of coordination or balance.
• Detect an aneurysm in the brain or in a blood vessel leading to the brain. The test may help your doctor decide if a procedure is needed to repair the aneurysm.
• Check the pattern of blood flow to a tumor. This can show if the tumor has spread and can help guide treatment.

You will need to take off any jewelry. You may need to take off all or most of your clothes. You will be given a gown to wear during the test.

The test may take several hours, so you will empty your bladder just before it starts.

During the test

You will likely have an intravenous (I.V.) line in a vein in your arm so your doctor can give you medicine or fluids if needed. A device called a pulse oximeter, which measures oxygen levels in your blood, may be clipped to your finger or ear. Small pads (electrodes) are placed on your arms, chest, or legs to record your heart rate and rhythm.

You will lie on your back on an X-ray table. Ask for a pad or blanket to make yourself comfortable. A strap, tape, or sandbags may be used to hold your body still. A lead apron may be placed under your genital and pelvic areas to protect them from X-rays.

A round cylinder or rectangular box that takes the pictures during fluoroscopy will be moved above you. The fluoroscope will move under you during the test.

The place where the catheter will be inserted (in the groin or above the elbow) will be shaved and cleaned. Your doctor will numb the area with a local anesthetic. Then your doctor will put a needle into the blood vessel. A guide wire will be put through the needle into the blood vessel and the needle will be removed. The catheter then will be placed over the guide wire and moved into the blood vessel. The catheter will be guided through the blood vessels until the tip is in the area to be studied. Your doctor will use the fluoroscope to watch the movement of the catheter in the blood vessels.

When the catheter is in place, the dye is injected through it. You may be asked to take a breath and hold it for several seconds. Several X-ray pictures will be taken one after another. These will be ready right away for your doctor to look at. You need to lie very still so the pictures are clear. More pictures may be taken.

After the test

The catheter is taken out after the angiogram. Pressure may be applied to the area where the catheter was put into your blood vessel. This will help prevent bleeding. A small device may also be used to close the blood vessel. You may have a bandage or a compression device on the catheter site.

If the catheter was put in your groin, you will need to lie still and keep your leg straight for up to a few hours. The nurse may put a weighted bag on your leg to keep it still. If the catheter was put in your arm, you may be able to sit up and get out of bed right away. But you will need to keep your arm still for at least 1 hour.

The place in your hands and feet where your heartbeat (peripheral pulse) can be felt may be marked with a pen. Your pulse may be checked before and after the angiogram.

Do not eat or drink for 4 to 8 hours before the angiogram. You may be asked to not take aspirin, aspirin products, or blood thinners for several days before the test and for 1 day after the test. If you take these medicines, talk with your doctor.

An angiogram can be done on an inpatient or outpatient basis. If you are an outpatient, you will stay in a recovery room for several hours before you go home. Arrange to have someone take you home, because you may get a sedative before the test. If you stay overnight in the hospital, you will likely go home the next day.

Also before the test you may have other blood tests. These include blood clotting (coagulation) studies, blood urea nitrogen (BUN), and creatinine.

Your doctor may tell you some results right after the test. Full results are usually ready the same day.