Examinations | Cerebral angiography (blood vessel examination of the brain)

This page will explain the procedure, the angiography study, and information about the events surrounding this procedure.

Angiography

An angiography is a medical examination by which a doctor (interventional radiologist) portrays the blood vessels of the human body. After local anesthesia of the groin, a thin tube (catheter) is placed in the femoral artery. Through this catheter contrast fluid can be injected and blood vessels can be examined precisely by making radiographs. The test is not painful (except for local anesthesia of the groin) and usually lasts half an hour. You lie on your back on the angiography table with the head in a support. The dye can give temporarily a warm feeling in the head and throat, sometimes light flashes in the eyes can occur briefly and also a feeling of dizziness.

Exams cerebral angiography 1
– Angiography: catheter examination of blood vessels from the femoral artery –

For this study, a hospital admission with an overnight stay is required. The next day you are discharged, but you should not drive a car yourself. During 3 days you should avoid strenuous exercises (sports, cycling, physical labor at work or at home) to prevent bleeding in the groin.

Exams cerebral angiography 2
– Biplane angiography unit –

Before the examination

  • It is important to inform the doctor or nurse on the following:
    • Pregnancy
    • Allergies, especially contrast allergy
    • Medication use
  • Use of medication should be consulted with your physician. Especially important to discuss is the use of blood thinners (aspirin, Ascal, Asaflow, Plavix, Clopidigrel, Ticlid, Marevan, Warfarin, fraxiparin, etc).
  • If you are contrast allergic, you should be premedicated. Generally, you need to take a Medrol 35mg tablet the evening before the examination.
  • You need to be sober for the treatment. This means that from midnight the day before the examination you should no longer eat or drink. On the day of the study, only take the necessary medication with a little water.

Illness or foreclosure

Ordinarily, your doctor or you yourself made an appointment for the examination. If due to any reason you are unable to pass the examination, kindly get in touch with the radiology department. This can be done via the telephone 03 821 3803. Please make a new appointment, if possible.

Hospital admittance

You are about 1.5 days in the hospital. This is usually on the ward A4 (4th floor) at the neurosurgery department. On the morning of the admittance you need to be sober (last meal taken before midnight). You check in at the central reception area of the hospital, then you will be referred to the ward. There, you will received by a nurse who can arrange all the practical issues. At the ward there is a attending physician present.

Conduct of the examination

You get a drip into the vein to be able to administer medication if necessary. You are transported in your bed from the ward to the angio room (special study room in the radiology department, 2nd floor). For the investigation you get a special dress skirt. It is recommended just before the investigation to go to the toilet to empty your bladder, because after the investigation you have prolonged bed rest.

In the angio room you have to lie on your back on the examination table. The nurse will shave the right groin for the examination and disinfect this area. Because of the examination of blood vessels of the head, your head is placed in a special headrest. The interventional radiologist will cover you with sterile drapes and then an anesthetic sting in the groin is given. The examination will start with the insertion of a small work tube in the femoral artery. Then, the interventional radiologist will investigate the specific target blood vessels with a catheter, which is shifted over a very thin metal wire ( guide wire). This insertion of the catheter and guidewire is painless. Once the catheter is positioned in the right place, the actual investigation starts. Contrast will be injected through the catheter, and then x-rays are made. You can feel a temporary heat sensation and depending on the surveyed area you may feel a stinging, see light flashes or experience dizziness for a short period. While taking the pictures it is very important to lie as still as possible with your head. Sometimes you will also asked not to breath or swallow. After the examination, the interventional radiologist will remove the catheter and guidewire as well as the work tube in the groin. The puncture site is then tightly pressed for at least 10 to 15 minutes. Next, you will be returned to the ward.

Exams cerebral angiography 4Exams cerebral angiography 5
  1. Both main arteries of the large brain hemispheres (internal carotid artery)
  2. Main artery of the small brain (basilar artery) with an aneurysm on the basilar tip.

After the treatment

The patient has strict bed rest until the next day. To prevent a bleeding at the puncture site (groin) the patients has to keep his/her right leg immobile for at least 4 hours and needs to lie on his/her back. Try not to use the abdominal muscles (no coughing or sneezing, no toilet, …). After 4 hours, the patient may turn and lie on the side, but bed rest is provided until the next morning. Driving a car yourself is not advised the first day. Also, you need to be careful with sport, heavy labor, and weight lifting the first 2 days.

Pain, discomfort and risks

Usually only the anesthetic needle before the femoral puncture and the compression of the groin after the examination might be unpleasant. Sometimes the artery is still painful, but normally the examination is painless. Should you feel pain during the examination, you must always report this to the doctor. Furthermore, the bed rest until the next day might also be uncomfortable.

By injecting contrast, the following effects might occur: warmth, strange taste in the mouth or throat, sometimes temporary nausea. Rarely, allergic reactions occur (redness, skinn rashes / swelling, hoarseness, chest tightness, …) or adverse effects on the kidneys (especially in people with preexisting poorer kidney function). Sometimes a bleeding can happen in the groin (pain, swelling, blood loss).

Results of the study

The results of the study is discussed with you the same or next day. Sometimes this is not possible and an consultation appointment is made.

Additional questions

If you have any questions, please feel free to contact the treating doctor, specialist nurse or radiologist from the department number of the UZA angiography (03 821 3803).