Medicine

Patient information for Translation

Your Cerebral Angiogram

What is a cerebral angiogram?

A cerebral angiogram is an X-ray test which provides highly detailed pictures of the blood vessels in your head and neck. This factsheet explains what the procedure involves and how to prepare for it.

Why am I having an angiogram?

CT and MRI scans can give important information, but a cerebral angiogram provides us with the greatest possible detail and allows us to see blood flow through the brain in real time. This information may be required to give an accurate diagnosis and offer you the best management for your condition.

Who will be doing the angiogram?

A dedicated team will perform the test for you. Everyone in the room has a particular role to play but they are all there for you. A specially trained doctor called an Interventional Neuroradiologist will carry out the procedure and analyse the images of the brain. A radiographer will operate the X-ray machine and nurses will be there to prepare the operating room, help look after you and assist during the procedure itself.

Preparing for the test

We will ask you to attend a clinic appointment before the angiogram so we can explain the procedure and answer any questions you may have. If you are happy to go ahead with the test, we will ask you to sign a consent form and take a blood test ready for the day of the procedure.

On the day of your angiogram

You will need to come to the Day Admissions Ward at the Royal London Hospital on the 3^rd floor at 7am. You may have a light breakfast (such as tea or coffee and toast), before you leave home. From then on, only drink clear fluids up until your procedure.

Please take all your medication as usual unless instructed otherwise by the doctor you saw in clinic (this includes any aspirin-based or anti-platelet medication, e.g., clopidogrel).

When you arrive on the ward, we will ask you to change into a hospital gown. We will arrange for you to come down to the radiology department as soon as we are ready for you.

When you arrive, the radiology staff will check you in and get you ready for the test. The procedure will take at least one hour so you should try to use the toilet at around this time.

During the angiogram

We want you to feel as comfortable and relaxed as possible during the procedure. If you feel cold, we can provide you with a blanket. We can also play some quiet music in the background if you would like.

You will be asked to lie down on the X-ray table and blood pressure and pulse monitoring equipment will be attached to your left arm.

The doctor will decide if we can use the artery in your wrist for the test, if this is not possible, we will use the artery in your leg.

The skin over your right wrist or upper leg will be cleaned with antiseptic, you will then be covered with a sterile sheet which comes up to your chin.

The skin over your wrist/upper leg will be injected with local anaesthetic. This stings at first but soon becomes numb.

A small needle is gently inserted into the blood vessel in your leg or wrist. A fine wire and thin plastic tube is then maneuvered towards the heart, and then up into the neck using X-rays and X-ray dye to guide the way.

You cannot feel the catheter tube inside your body, but you may feel the dye when it is injected.

When the catheter is in place, the X-Ray machine is repositioned ready to take the pictures.

It’s very important that you stay very still whilst we take the pictures. Close your eyes and keep your head still. Don’t take deep breaths or swallow while the pictures are taken.

The injections can make you experience a hot flush, flashing lights, and a strange taste in your mouth. This will pass after 10 seconds or so.

The catheter is moved to the different vessels until all the pictures have been taken.

After the Angiogram

When all the vessels have been imaged, the catheter tube will be removed, and we will compress the small hole in the artery in your wrist or upper leg.

If the angiogram was performed through the wrist, we will put a special plaster (StatSeal) over the puncture site and inflate a wristband over this to stop the bleeding. The wristband will be slowly deflated and removed after 35 minutes but the StatSeal plaster should stay on for 24 hours.

If the procedure was performed through the leg, we will insert a small plug into the artery to stop it bleeding. The plug will remain in the body and does not need to be removed. This plug can get dislodged if you put the artery under any strain. To avoid this, you will need to lie flat in bed for at least 2 hours after the procedure and take care not to stretch or strain over the next few days until the artery is fully healed.

We will monitor your pulse, blood pressure and the arterial puncture site for a couple of hours after the angiogram. If you feel unwell or have any concerns, please speak to a member of staff. Most people can go home a couple of hours after the procedure.

Are there any risks involved?

No medical procedure is without risk. The angiogram is minimally invasive and relatively safe. The most concerning complication, though very rare, is the possibility of a stroke. This occurs in less than one in 200 patients. A stroke can be of any severity and in exceptional cases, it may be life threatening.

Bleeding from the artery puncture site in the leg rarely causes problems (1 in 200 patients). If you notice a lump at the site, you should press hard on it and go to your nearest A&E.

Maneuvering wires and tubes inside blood vessels can damage them (1 in 500 patients). If this happens it may be necessary to give you medication while the vessel heals. Use of X-rays to guide the doctor during the procedure helps to minimise this risk.

When you return home

You should ensure that someone stays with you for the night following the angiogram. We advise you to avoid heavy lifting or strenuous exercise for a week until the artery is fully healed.

Results of the angiogram

Your condition and imaging will be discussed in a meeting with other specialist doctors to agree the best treatment to offer you. We will then see you in clinic to discuss this with you. We may be able to offer you treatments delivered from inside the vessels (endovascular treatment), just like the angiogram itself. You may prefer this less invasive treatment to a neurosurgical procedure.

Large print and other languages
This information can be made available in alternative formats, such as easy read or large print, and may be available in alternative languages, upon request. For more information, speak to your clinical team.
 

এই তথ্যগুলো সহজে পড়া যায় অথবা বৃহৎ প্রিন্টের মত বিকল্প ফরম্যাটে পাওয়া যাবে, এবং অনুরোধে অন্য ভাষায়ও পাওয়া যেতে পারে। আরো তথ্যের জন্য আপনার ক্লিনিক্যাল টিমের সাথে কথা বলুন।

Na żądanie te informacje mogą zostać udostępnione w innych formatach, takich jak zapis większą czcionką lub łatwą do czytania, a także w innych językach. Aby uzyskać więcej informacji, porozmawiaj ze swoim zespołem specjalistów.

Macluumaadkaan waxaa loo heli karaa qaab kale, sida ugu akhrinta ugu fudud, ama far waa weyn, waxana laga yabaa in lagu heli luuqaado Kale, haddii la codsado. Wixii macluumaad dheeraad ah, kala hadal kooxda xarunta caafimaadka.

Bu bilgi, kolay okunurluk veya büyük baskılar gibi alternatif biçimlerde sunulabilir, ve talep üzerine Alternatif Dillerde sunulabilir. Daha fazla bilgi için klinik ekibinizle irtibata geçin.

یہ معلومات متبادل فارمیٹس میں دستیاب کی جا سکتی ہیں، جیسا کہ پڑھنے میں آسان یا بڑا پرنٹ  اور درخواست پر متبادل زبانوں میں بھی دستیاب ہو سکتی ہیں۔ مزید معلومات کے لیے، اپنی کلینکل ٹیم سے بات کریں'۔

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Reference: BH/PIN/710

Publication date: June 2022

All our patient information leaflets are reviewed every three years.

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