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Cerebral Angiography

Last updated April 25, 2018

DoveMed.com

Cerebral angiography showing blood vessels in the brain.


Background Information:

What are the other Names for the Procedure?

  • Angiography - Head
  • Cerebral Angiogram
  • Vertebral Angiogram

What is Cerebral Angiography radiology procedure? (General Explanation)

  • A Cerebral Angiography is used to produce images of blood vessels in the brain
  • A thin tube, called a catheter, is inserted into an artery in this procedure
  • A contrast material is injected through the catheter and images are captured

What part of the Body does the Procedure involve?

A Cerebral Angiography involves an analysis of the brain.

Why is the Cerebral Angiography radiology procedure Performed?

  • Cerebral Angiographies are used to diagnose conditions related to blood vessels in the brain, such as blood clot, vasculitis, tumor, aneurysm, narrowing of arteries, and tear in the lining of the artery
  • They produce images of the arteries in the head and neck region
  • A Cerebral Angiography is recommended, when the patient has complaints about memory loss, slurred speech, headaches, blurred vision, or a loss of balance

What is the Equipment used? (Description of Equipment)

The equipment used for a Cerebral Angiography could include:

  • Catheter
  • Contrast dye
  • X-ray tube
  • Electrocardiogram
  • Computer monitors

An image intensifier located over the patient, who is lying on the table, converts x-rays into a video image.

What are the Recent Advances in the Procedure?

There have been no recent advances to replace the Cerebral Angiography procedure.

What is the Cost of performing the Cerebral Angiography radiology procedure?

The cost of the Cerebral Angiography procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

When do you need a Second Opinion, prior to the Procedure?

  • It is normal for a patient to feel uncomfortable and confused with a sudden inflow of information regarding Cerebral Angiography procedure and what needs to be done
  • If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician
  • Also, if the procedure involves multiple steps or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently

What are some Helpful Resources?

http://www.nlm.nih.gov/medlineplus/ency/article/003799.htm

http://www.patient.co.uk/health/cerebral-angiography

http://www.strokecenter.org/professionals/stroke-diagnosis/guide-to-imaging-techniques-in-stroke-diagnosis/cerebral-angiography/

Prior to Cerebral Angiography radiology procedure:

How does the Cerebral Angiography radiology procedure work?

  • Cerebral Angiographies work on similar principles of an x-ray machine
  • X-rays are aimed at different parts of the body and an image is produced on a recording plate, using x-rays that have passed through the body
  • Contrast materials, such as barium, is also used to visualize the blood vessels

How is the Cerebral Angiography radiology procedure Performed?

  • In the preparation room, the nurse inserts an intravenous (IV) line in the arm
  • A blood sample is drawn in to see that the kidneys are working properly
  • The area where the catheter is inserted, is shaved and numbed with an anesthetic
  • A catheter is inserted into the artery, by making a small incision on the skin
  • The catheter is guided to the area of interest
  • The contrast material is injected through the catheter, to visualize the artery of interest
  • Several X-ray images are taken
  • Catheter and IV  are removed and the incision site is closed
  • The whole procedure takes about 1-3 hours, or more

Where is the Procedure Performed?

The Cerebral Angiography is performed as an outpatient procedure, at a hospital.

Who Performs the Procedure?

The following specialists may perform a catheter Cerebral Angiography:

  • Neuroradiologists
  • Neurosurgeons
  • Pediatric neurosurgeons
  • Vascular and interventional radiologists
  • Vascular neurologists

How long will the Procedure take?

The procedure may take anywhere from 1-3 hours to perform. However, there may be some waiting time involved, before and after the procedure.

Who interprets the Result?

  • A radiologist or neurologist interprets the images taken from the Cerebral Angiography procedure, to determine any blockage of blood flow
  • After the procedure, follow-up visits may be needed

What Preparations are needed, prior to the Procedure?

The following preparations may be needed prior to a Cerebral Angiography procedure:

  • Do inform your medical professional about any allergies, especially related to barium or iodinated contrast material, used in the procedure
  • Avoid wearing metal objects or jewelry, as it interferes with the x-rays
  • The patient may be asked to avoid taking aspirin, blood thinners, or any non-steroidal anti-inflammatory drugs, for a while, prior to the procedure
  • It is highly recommended to inform your physician or the medical professionals, if you are pregnant or breast feeding
  • The patient may be asked not to eat or drink anything for 8 hours, prior to the exam
  • The patient may have to stay at the hospital for overnight observation; they may also need someone to drive them home, if any sedatives have been administered

What is the Consent Process before the Procedure?

A physician will request your consent for Cerebral Angiography procedure using an Informed Consent Form.

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.

You must sign the forms only after you are totally satisfied with the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What are the Benefits versus Risks, for this Procedure?

Following are the benefits of the procedure:

  • By using Cerebral Angiography, it is possible to diagnose and treat the condition, at the same time. For example, a narrowing of the artery, can be treated by angioplasty and placement of stent, during the procedure
  • It may eliminate the need for a surgery
  • This method is more accurate than carotid doppler ultrasound
  • It produces very detailed images of the blood vessels
  • The radiation does not stay in a patient’s body, after the procedure

Following are the risks of the procedure:

  • Over-exposure of radiation may cause cancer; though, this is very rare
  • Contrast materials used in the procedure may in some rare cases, cause allergic reaction in some patients
  • If the contrast material leaks out under the skin, it may cause some skin damage
  • Very rarely, a blood clot may form on the tip of the catheter and blocks the artery
  • Internal bleeding may occur, if the catheter punctures the artery; but, this is a very rare possibility

What are the Limitations of the Cerebral Angiography radiology procedure?

This procedure is not recommended for patients with kidney disorders or diabetes.

What are some Questions for your Physician?

Some of the basic questions that you might ask your health care provider or physician are as follows:

  • What is a Cerebral Angiography procedure?
  • Why is this procedure necessary? How will it help?
  • How soon should I get it done? Is it an emergency?
  • Who are the medical personnel involved in this procedure?
  • Where is the procedure performed?
  • What are the risks while performing the procedure?
  • What are the complications that might take place, during recovery?
  • What are the possible side effects from the procedure? How can I minimize these side effects?
  • How long will it take to recover? When can I resume normal work?
  • How many such procedures have you (the physician) performed?
  • Are there any lifestyle restrictions or modifications required, after the procedure is performed?
  • Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
  • Is there any medication that needs to be taken for life, after the procedure?
  • What are the costs involved?

During the Cerebral Angiography radiology procedure:

What is to be expected during the Cerebral Angiography radiology procedure?

The following may be expected during a Cerebral Angiography procedure:

  • There may be a little pain, when the needle is inserted for IV line
  • Contrast materials used in the procedure may cause warm sensations
  • As a local anesthetic is used at the site of catheter insertion, the procedure is mostly painless
  • The patient may ask for a blanket or pillow, because the x-ray table may feel hard and cold

What kind of Anesthesia is given, during the Procedure?

Local anesthesia may be used to numb the area, where the catheter is inserted, during the Cerebral Angiography procedure.

How much Blood will you lose, during the Procedure?

Since the procedure is a minimally invasive procedure, the blood loss involved during the procedure is minimal.

What are the possible Risks and Complications during the Cerebral Angiography radiology procedure?

The following risks are possible during the procedure:

  • In rare cases, an allergic reaction to the contrast dye
  • Blood clot or bleeding at the needle stick site, which could partly block blood flow to the leg
  • Damage to an artery or artery wall from the catheter, which can block blood flow and cause a stroke (in very rare cases)

What Post-Operative Care is needed at the Healthcare Facility after the Cerebral Angiography radiology procedure?

  • Generally, no significant post-operative care is needed at the healthcare facility
  • However, a short period of observation may be occasionally recommended by your healthcare provider

After the Cerebral Angiography radiology procedure:

What is to be expected after the Cerebral Angiography radiology procedure?

The following may be expected after a Cerebral Angiography procedure:

  • The patient may feel a slight tenderness or bruising at the site of the injection, after the procedure
  • The patient will be transferred to a recovery room and monitored for a period of 4-6 hours, after the Cerebral Angiography, before going home
  • The patient should be able to resume their normal activities within 24 hours
  • However, they should avoid driving for a period of 24 hours and lifting heavy objects or climbing stairs, for a period of 48 hours

When do you need to call your Physician?

Do inform your physician or health care provider, in case you develop an infection with symptoms, such as:

  • Bleeding
  • Chest pain
  • Difficulty walking or talking
  • Dizziness
  • Facial weakness
  • Fever
  • Numbness or pain
  • Slurred speech
  • Unusual swelling
  • Vision problems

What Post-Operative Care is needed at Home after the Cerebral Angiography radiology procedure?

No specific post-operative care is needed at home after the procedure.

How long does it normally take to fully recover, from the Procedure?

  • The patient should be able to resume their normal activities within 24 hours
  • However, they must avoid driving for the next 24 hours
  • They must also avoid lifting heavy objects or climbing stairs for the next 48 hours

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

A Cerebral Angiography procedure does not involve the removal of any body tissue.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

Since no tissue is removed during the procedure, a pathologist does not get involved in the care of the patient.

Who will you receive a Bill from, after the Cerebral Angiography radiology procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the health care facility has with the physician and other healthcare providers. 

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

  • The hospital, where the procedure is performed
  • Radiologist or neurologist, performing the procedure
  • Healthcare providers, physicians, who are involved in the process

The patient is advised to inquire and confirm the type of billing, before the Cerebral Angiography procedure is performed.

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Feb. 22, 2014
Last updated: April 25, 2018