Angiogram

Angiograms reveal problems occurring in blood vessels—particularly those in or surrounding the brain and heart. An angiogram will display how blood moves around an obstruction such as a clot, as well as through a narrowing in a blood vessel wall. It can also show where a weakness in an artery wall could lead to an aneurysm.

Cerebral angiograms are mainly concerned with diagnosing problems in the blood vessels of the brain. At Baptist Neurology Group, our physicians sometimes rely on this procedure to evaluate an abnormal blood vessel, check for an aneurysm, assess the narrowing of an artery, confirm or check a brain tumor, locate a clot that could cause a stroke, or check arteries before performing surgery. Other neurological conditions that might call for an angiogram include swelling (edema) of the brain, narrowing caused by a spasm (vasospasm), increased intracranial pressure (ICP) or fluid within the brain (hydrocephalus).

Interventional angiograms: In some cases, doctors performing a diagnostic angiogram might use the catheter to actually treat a problem. In addition to delivering contrast dye used in imaging studies, the catheter might be used to:

• Deliver medication to the site of a stroke or tumor
• Reopen a blocked brain artery
• Stop internal bleeding

If you or a loved one have been told you need any kind of angiogram, contact us at Baptist Neurology Group.

For all diagnostic tests, there are detailed safety protocols that must be followed during and after the procedure itself. This is especially true for angiography.

Before you come to the site for your angiogram, you may be asked to take a blood test to see how quickly your blood forms a clot or to assess other factors. You’ll be asked to list all prescription and over-the-counter medications and supplements you’re taking. You may be asked to adjust your diet and medication regimen—especially if you’re taking blood thinners, aspirin or other medications for clotting. Your doctor will probably instruct you to fast for a specific period. Since recovery from an angiogram can last 12 to 24 hours, be prepared for the possibility that you’ll spend the night at the facility. You should arrange for someone to take you home. Finally, it’s important to notify your physician if any of several conditions apply to you:

• If you’re sensitive or allergic to iodine, seafood, latex, surgical tape or any medications (especially local or general anesthetics)
• If you are or might be pregnant
• If you are breastfeeding
• If you have asthma or kidney problems
• If you have diabetes, especially if you take metformin (Glucophage)

When you arrive for your procedure: Your physician or a technician will explain the procedure in detail, answer your questions and ask you to sign a consent form. You’ll be asked to remove clothing, jewelry, dental appliances and other personal items and change into a hospital gown. You’ll be asked to empty your bladder and may be given a sedative to help you relax. If you are given anticholinergic medication to reduce activity in the intestines, your mouth may feel dry.

During the procedure: The procedure takes between one and three hours. Technicians may hook up a heart monitor and other devices to monitor vital signs like heart rate, blood pressure and breathing. An intravenous (IV) line will probably be used to keep you hydrated and to deliver medications to relieve pain or anxiety. The site for inserting the catheter will be prepared and numbed, and the catheter will be inserted. Once it is in place, contrast dye will be injected through the catheter. You may briefly feel flushed, notice a metallic taste or experience other sensations. These typically last only a few seconds. A series of x-ray images will be created either on film or digitally. When the imaging process is complete, the catheter will be removed, and pressure will be applied to the site.

Following the procedure: You’ll spend several hours in a recovery room where you will be monitored until you are ready to return to your home or hospital room. It’s important to drink lots of fluids to help flush the contrast dye from your body. If you had the angiogram done as an outpatient, someone must drive you home. Continue to drink fluids for 24 hours to help flush out the contrast dye and prevent dehydration. Unless your physician directs otherwise, you can resume normal daily activities as you feel ready. Be alert for any changes near the site of your catheter insertion.

Call your doctor immediately if you experience dizziness, shortness of breath or fever, or if you notice these symptoms at the insertion site: pain, swelling, tingling, numbness or signs of infection. Infection signs include redness, warmth, pain or swelling, red streaks, pus drainage, swollen lymph nodes, chills and fever.

Call 911 immediately (not your doctor) if you experience:

• Chest pain
• Serious breathing difficulty
• Slurred speech
• Vision problems
• Muscle weakness in the arms, legs or face
• Severe abdominal or back pain

Learn about other diagnostic procedures and some of the conditions we treat. If you or a loved one needs to schedule an angiogram, contact us at Baptist Neurology Group. We can arrange the procedure for you at a time and place that’s convenient for you.

Because angiography is an invasive procedure (i.e. the instruments enter your body), it carries more risk than noninvasive diagnostic imaging. Despite numerous precautions and safety protocols, there’s a slight chance of complications. These could include:

• An allergic reaction to the contrast dye could occur, even if you reported allergic sensitivity to the substances listed. Mild reactions such as itching, hives or a rash, can be treated easily. If the reaction is severe enough to cause difficulty breathing or swallowing, call 911 immediately.
• There’s a very slight chance that the catheter could break off a clot or fatty deposit or damage the inside of the blood vessel. This could cause blockage in the intestine, brain or extremities. The catheter could damage the inside of a blood vessel. This can be corrected surgically.
• The insertion site could start bleeding after you return home. Usually this is minor and easily stopped by applying constant pressure. If you cannot stop the bleeding, call 911 immediately.
• The contrast dye could damage the kidneys, despite precautions taken to avoid it, especially in people who are dehydrated or who have kidney problems or diabetes.
• Because x-rays are involved, there is a very slight chance of damage from exposure to radiation. This is magnified if you have had frequent x-ray or nuclear medicine exposure in the past.  If you are pregnant, the angiogram should not be performed because the radiation could damage the developing fetus. If you are breastfeeding, use formula for a few days after the procedure.

At Baptist Neurology Group, we know it can be scary to undergo a diagnostic procedure like angiography. So we treat patients with a blend of expertise and compassion. Learn about other diagnostic tests and the conditions we treat every day. If you need an angiogram, contact any of our offices conveniently located throughout the Jacksonville area for an appointment.