A cerebral Angiogram (also called cerebral digital subtraction angiography or DSA) is the gold standard for assessing blood vessels in the brain, head, neck and spine. The procedure provides far greater detail than CT and MRI scans and is essential to understand the anatomy of aneurysms and diagnose vascular malformations. It provides important information which guides decision making regarding the most effective and safest way to treat your condition.
How is it performed?
The procedure is usually performed as a day case. Arrangements can be made to stay in hospital overnight if medically indicated.
The procedure can be performed with or without sedation or under a short general anaesthetic.
The angiogram is performed in a special operating theatre equipped with an Xray machine. You are positioned on your back. A small plastic sheath is placed in the femoral artery over the hip joint or in the radial artery at the wrist under ultrasound guidance to ensure correct positioning. A catheter (long plastic tube) is then navigated to the desired artery and images are obtained by injecting an Xray contrast dye into the blood vessel whilst taking pictures with an Xray machine.
What happens following the procedure?
Once the procedure is complete the plastic sheath is removed and the very small hole in the artery is closed with a special stitch, you will then spend a short time in the recovery area, followed by the day procedure unit. You will need to stay flat in bed for 4 hours following the procedure to decrease the risk of bruising in the leg. Following 4 hours bed rest you will be able to mobilise gently. Heavy lifting and strenuous exercise should be avoided following the procedure. The small clear dressing can be removed after 3 days.
How long does the procedure take?
The procedure generally takes 30 mins to 60 mins to perform
Will there be a follow up appointment?
An appointment will be made to see Dr Bell in rooms the week following the angiogram to review the results of the procedure and discuss ongoing management.
What are the risks or possible complications?
A cerebral angiogram is a very safe procedure if performed by a specialist with further training in Neurointervention, however all medical procedures carry some risk.
There is a risk of stroke from the procedure if plaque from the vessel wall or thrombus from the catheter dislodges and travels to the brain however this is very uncommon. Other complications such as bleeding / bruising in the leg, internal bleeding, arterial damage, infection or allergic reactions also occur very rarely. Dr Bell will discuss all risks with you prior to the procedure to ensure you are well informed and any questions you may have can be discussed at this time.
Do I need to fast for the procedure?
Yes, specific instructions regarding fasting will be given to you at the time of booking the procedure.
Please let Dr Bell know if:
- You are on any blood thinning medications (also called anticoagulants or antiplatelet medicine)
- If you are on medication for diabetes
- If you may be pregnant
- Have poor renal function
- Any allergies to medications or Xray contrast dyes