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Cerebral angiography How the Test is Performed:
This test is done in the hospital. You will be asked to lie on the X-ray table. Your head is positioned and immobilized by using a strap, tape, or sandbags. Electrocardiogram ( ECG ) leads are taped to your arms and legs to monitor your heart during the test. An ECG is a procedure in which patches (electrodes) are put on the body surface to trace the electrical impulses of the heart. The area where the contrast medium will be introduced is shaved and cleansed. The site is usually in the leg. You are given a local anesthetic, the artery is punctured, and a needle is inserted into the artery.
The catheter (a long, narrow, flexible tube) is inserted through the needle and into the artery. It is then threaded through the main vessels of the abdomen and chest until it is properly placed in the arteries of the neck. This procedure is monitored by a fluoroscope (a special X-ray that projects the images on a TV monitor). The contrast medium is then injected into the neck area through the catheter, and the X-ray pictures are taken. The catheter is kept open by flushing it periodically with a saline solution containing heparin, which will keep the blood in the catheter from clotting. Your pulse , blood pressure , and breathing are monitored during the procedure.
After the X-rays are taken, the needle and catheter are withdrawn. Pressure is immediately applied on the leg at the site of insertion for 10 to 15 minutes to stop the bleeding . After that time, the area is checked and a tight bandage is applied. Your leg should be kept straight for 12 hours after the procedure.
How to Prepare:
- Advise the health care provider if you are pregnant or if you have ever had any bleeding problems. Allergic reactions to X-ray contrast material or any iodine substance and any other allergic reactions should be mentioned.
- You must sign a consent form.
- Routine blood tests will be done and an examination of the nervous system performed before the procedure.
- Food or fluid may be restricted 4 to 8 hours before the procedure.
- You will be given a hospital gown to wear. You must remove all jewelry.
- A sedative or pain pill may be given to you before the procedure.
Infants and children:
The physical and psychological preparation you can provide for this or any test or procedure depends on your child's age, interests, previous experience, and level of trust. For specific information regarding how you can prepare your child, see the following topics as they correspond to your child's age:
How it Feels:
The X-ray table is hard and cold, but you may ask for a blanket or pillow. There is a sting when the anesthetic is given. This does not numb the artery, so there will be brief, sharp pain as the catheter is inserted. There is a feeling of pressure as the catheter is advanced.
As the dye is injected, there is a burning sensation. You may experience a headache or feel flushed on the side of the face. There is tenderness and bruising at the site of the injection after the test.
Risks:
There is the possibility of significant risk. A reaction to the contrast medium can occur. There is some risk of the catheter damaging the artery or knocking loose a piece of the artery wall which can block the blood flow and cause a stroke . This is rare, however. A clot or bleeding at the puncture site may result in a partial blockage of the blood to the leg.
There is low radiation exposure, however, most experts feel that the risk of most X-rays is smaller than other risks we choose to take every day. Pregnant women and children are more sensitive to the risks of the X-ray .
Why this Test is Performed:
The test is most frequently used to confirm cases of stroke , tumor , bulging of the artery walls, a clot , a narrowing of the arteries, and to evaluate the arteries of the head and neck before a corrective surgery. It is used to get more exact information after something abnormal has been detected by a CT scan of the head or brain.
Normal Values:
The X-ray shows normal structures for the age of the patient.
Abnormal Results:
If the contrast medium flows out of the blood vessel, it may indicate internal bleeding . Narrowed arteries may suggest cholesterol deposits, a spasm, or inherited disorders. If the vessels are displaced, it may be caused by tumors or bleeding within the skull, aneurysm (bulging of the artery walls), or malformation.
Additional conditions under which the test may be performed:
Cost:
The estimated cost is $1,500.
Special Considerations:
If you have facial weakness , slurred speech , visual trouble, or your leg becomes numb during or after the procedure, notify the health care provider immediately.
This is an illustration of the major areas of the brain. Each area has one or more specific functions.
A carotid arteriogram is an X-ray study designed to determine if there is narrowing or other abnormality in the carotid artery, a main artery to the brain. This is an angiogram of the left common carotid artery (both front-to-back and side views) showing a severe narrowing (stenosis) of the internal carotid artery just beyond the division of the common carotid artery into the internal and external branches .
This is an angiogram of the right carotid artery showing a severe narrowing (stenosis) of the internal carotid artery just past the carotid fork. There is enlargement of the vein or ulceration in the area after the stenosis in this close-up film. Note the narrowed segment toward the bottom of the picture.
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