The doctor uses a catheter—a long, flexible tube—and an external X-ray to get very detailed images of these vessels. Using the catheter, your doctor injects a contrast dye into your carotid artery. The carotid artery is the blood vessel in your neck that carries blood to your brain. The contrast material helps the X-ray create a clear picture of your blood vessels so that your doctor can identify any blockages.
Cerebral angiography is also called “intra-arterial digital subtraction angiography.”
Not every patient who may have arterial blockages needs cerebral angiography. Because it is invasive and carries some risks, it is usually performed only after noninvasive testing if your doctor needs more information to plan your treatment.
Cerebral angiography can help diagnose:
- an aneurysm (a rupture in the wall of an artery)
- artherosclerosis (narrowing of the arteries)
- an arteriovenous malformation (a mass of dilated interconnected blood vessels)
- vasculitis (blood vessel inflammation)
- blood clots
- tears in the lining of an artery
Cerebral angiography may also help your doctor figure out the cause of certain symptoms, including:
- severe headaches
- loss of memory
- slurred speech
- blurred or double vision
- weakness or numbness
- loss of balance or coordination
You may not be able to eat or drink after midnight prior to the procedure. Talk to your doctor about how you should prepare.
Your doctor may ask you to stop taking certain medicines before the procedure. These include blood thinners, aspirin, and nonsteroidal anti-inflammatory drugs (NSAIDS), which can increase bleeding risk.
Some people are allergic to the contrast material used during the procedure. Tell your doctor if you have any allergies, including allergies to anesthesia. The doctor may prescribe anti-allergy medications before the test.
Certain illnesses and medical conditions can increase your risk of complications during the test. If you have diabetes or kidney disease, the contrast material can cause temporary damage to your kidneys. Women who are or think they may be pregnant should ask about radiation exposure during the test.
If you are breastfeeding, pump your milk before the procedure and don’t breastfeed again for at least 24 hours to give the contrast material time to leave your body.
Your healthcare team for this test may include a radiologist, a neurosurgeon who specializes in interventional radiology, and a radiology technician.
Most patients are sedated during the procedure. Others—especially children—are given general anesthesia. This is because, for the test to be effective, you must be still. The sedation will help you to feel relaxed and you may fall asleep. During the procedure, your head will be stabilized with a strap, tape, or sandbags. Again, it is very important that you lie still during the test.
Your doctor will sterilize an area of your groin. He or she will insert a catheter and thread it through your blood vessels and into your carotid artery, which is located in your neck.
A contrast dye will flow through the catheter and into the artery, where it will travel to the blood vessels in your brain. You may have a warm feeling as the contrast dye flows through your body. You will then have multiple head and neck X-rays taken.
Afterward, the catheter will be removed and a dressing will be placed over the insertion site. The entire procedure usually takes between one and three hours.
Cerebral angiography carries some rare but potentially serious risks. They include:
- stroke (if the catheter loosens plaque inside a blood vessel)
- damage to the blood vessels (including puncturing an artery)
- blood clots (which can form around the catheter tip)
Be sure to carefully discuss all risks with your doctor.
After the procedure, you will go to a recovery room where you will lie still for two to six hours before going home. At home, be careful not to lift heavy objects or overexert yourself for at least one week.
Call your doctor immediately if you experience the following:
- signs of a stroke (including slurred speech, weakness or numbness, or vision problems)
- redness and swelling at the catheter insertion site
- chest pain
A radiologist will interpret the results of your test. Your doctor will share these results with you and will talk to you about any follow-up tests or treatment.