Cerebral and Spinal Angiography
A diagnostic catheter cerebral or spinal angiogram is a procedure that is performed to acquire high-resolution images of the blood vessels of the head and neck or spine. This is also the foundation to all endovascular interventional procedures. After administering local anesthesia (usually lidocaine), an incision approximately 1/8 of an inch is made in the crease of the groin and a small sheath (a hollow plastic tube) is advanced into the femoral artery in the leg. A smaller catheter (a hollow plastic tube) is advanced through the sheath and navigated under x-ray guidance through the arterial system to the arteries that serve the head and the neck. Contrast dye is injected through the catheter into selected vessels and a series of x-ray images are rapidly acquired using two cameras positioned around the patient’s head. Catheter angiography affords the unique capability of evaluating dynamic and functional anatomy of the brain and spine with far greater resolution than non-invasive imaging such as CT or MRI. Characteristics of the circulation system including blood vessel anatomy and blood flow can be interpreted from the images.
The procedure is commonly performed with the patient awake but very sleepy, under “conscious sedation.” Sedation medications are administered to achieve patient comfort. During contrast injections, a patient may experience a sensation of warmth, flashes of lights, intermittent dizziness, or unusual tastes. These symptoms are well-tolerated, brief, and pass within seconds.
At the completion of the procedure, the catheter and sheath are removed, and pressure is applied to the leg or a small plug is placed to close the artery access site. The patient then recovers with flat bed rest for approximately 3 to 6 hours before returning home the same day.