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Cerebral angiogram risks and benefits explained

What Is A Cerebral Angiogram?

A cerebral angiogram, or also called cerebral angiography, is like a special video of your brain’s blood vessels. It helps doctors see how blood is flowing in your brain and find any problems in the blood vessels. An angiogram is a minimal invasive procedure.

Here’s how it works: They put a small tube called a catheter into a large artery, usually in your groin (the area where your leg meets your body). However, at Neurosurgeons of NJ they can do it through the wrist in most patients. Whether through the wrist or the groin, they use ultrasound to visualize the artery and numbing medication to access the artery. Then, they gently push the catheter through your blood vessels up to your neck area.

While the catheter is inside your blood vessels, they send in a special dye to flush the blood vessels in the brain. This dye shows up on special X-ray imaging and helps the doctors see your blood vessels really well. It’s like making a map of your brain’s blood highways.

With this map, they can check if there are any issues like blockages, narrow parts, inflammation of the arteries, arteriovenous malformations or leaks in your blood vessels. These issues can be a big deal because they might cause problems like strokes.

The whole test usually takes about 30 minutes, and you do NOT need to stay in the hospital overnight. You will have to arrive on an empty stomach, without anything to eat or drink for 8-12 hours. You will get some medication to allow you to sleep through most of the procedure, and for that reason someone else should drive you and pick you up afterwards. After the test, they’ll watch you for a few hours to make sure everything is okay, and then you can go home. You might need to take it easy for a couple of days, but you’ll get back to your normal routine soon.

So, a cerebral angiogram helps doctors look closely at your brain’s blood vessels to find and fix any problems they see, and it’s usually a safe way to do it. While a cerebral angiogram is a valuable tool for diagnosing certain brain-related conditions involving blood vessels, it’s important to be aware that this procedure comes with some small risks like any medical procedure. The likelihood of these risks varies from person to person based on factors like your overall health and age.

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Here are the potential risks:

  1. Bleeding: After the procedure, there’s a possibility of bleeding, swelling, numbness, or drainage from the injection site where the catheter was inserted, for example in the groin area. To prevent bleeding and allow the incision to heal properly, patients typically need to lie flat for a few hours.

Studies have shown that bleeding complications and overall complications are less common when accessing the artery through the wrist. Recovery is also faster, and you can go home faster after the procedure.

  1. Infection or injury at groin/wrist: While those complications are rare, particularly when accessing the artery through the wrist, they may require further care after the procedure.
  1. Reactions to Contrast Dyes or other medications: Some people may have an allergic reaction to the contrast dye used to make blood vessels visible. These reactions can range from mild itching and headaches to more severe responses like hives or even anaphylaxis. People with kidney problems should also be cautious, as the dye needs to be processed by the kidneys.
  1. Stroke: During the angiogram, there’s a small chance of having a stroke. This can happen when the catheter, a thin tube inserted into an artery, disturbs plaque from the artery walls, which might block blood flow. Blood clots can also form on the catheter and hinder blood flow in the arteries.
  1. Radiation Exposure: X-rays are used during the angiogram to guide the catheter and record blood flow in the brain. This exposes you to radiation, which can contribute to your lifetime radiation exposure risk.

It’s important to understand that while there are risks associated with a cerebral angiogram, there are also significant benefits. This procedure provides a much clearer and detailed view of the brain’s blood vessels compared to other imaging methods like MRI and CT scans. It enables doctors to diagnose conditions that might not be visible with those scans, especially those involving small arteries.

Additionally, cerebral angiograms allow doctors to not only see the blood vessels but also observe how blood flows through them. This helps pinpoint tiny areas of narrowing or leakage that might go unnoticed with MRI or CT scans.

The precise imaging made possible by contrast dyes also aids in planning treatments for conditions affecting blood vessels in the brain, such as balloon angioplasty, stent placement or aneurysm treatment.

Ultimately, whether or not you should undergo a cerebral angiogram depends on your individual circumstances, including your age, overall health, and the specific condition being investigated. Your medical team will work closely with you to determine if a cerebral angiogram is the most suitable diagnostic and treatment option for your situation.

Please call today to schedule a consultation with me. (551) 284-3265

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Dr. Dorthea Altschul

About Dr. Dorothea Altschul

MD, FAHA, FSVIN

Dr. Dorothea Altschul is an accomplished neurointerventionalist in North Jersey and is the Clinical Director of Endovascular Services at Neurosurgeons of New Jersey, practicing out of their Ridgewood office located on East Ridgewood Avenue.

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