During a Cerebral Angiogram

What happens during a cerebral angiogram, including catheter insertion, contrast injection, X-ray imaging and procedural details.

What happens on the day?

Typically you would enter the hospital on the day of the procedure. A nurse will go through your medical history. You will then be given a gown to wear during the procedure and remove your underwear. You will then be consented for the procedure by a doctor. You should use the toilet before the procedure.

The angiogram is done in a dedicated angiography suite where you will lie flat on the table. In the room there will be members of the team who help to perform the procedure, including a nurse, a radiographer/technologist (who will help operate the machine), and a doctor (usually an interventional neuroradiologist) who will perform the procedure.

The procedure

The wrist or groin is usually the site that is used for delivery of the instruments for the procedure and this is shaved and cleaned with sterile solution. Drapes are then placed around the site. The doctor will inject a small amount of local anaesthesia (which unfortunately stings when it goes in) to numb the skin. They will then insert a plastic tube in to the artery and navigate a long thin plastic tube called a catheter through the body and in to the blood vessels of the neck. Through this tube ‘contrast’ dye is injected whilst performing an X-ray to obtain images of the blood vessels. You do not feel the tube as it passes through the blood vessels in your body as they have no sensory receptors. You may feel some pushing and pulling at the groin.

The x-ray machines will move into position over your head. They will move around you during the procedure but will not touch you. You may experience funny sensations such as flashing lights in the eyes, hot or cold over the side of the face, a funny taste in the mouth, or pressure at the back of the head during the examination. These are all normal and tend to pass within a few seconds.. They result from the contrast dye travelling through the blood vessels. The whole examination usually takes less than an hour, although the time can be variable due to the ease or difficulty of the procedure.

It is very important you stay still throughout the procedure to ensure the pictures taken are as clear as possible. If you feel unwell or in pain please let us know. You can talk to your doctor during the exam.

After all the imaging is finished the tube in the access site is removed. If the puncture site was the groin sometimes a collagen “plug” is used to seal the blood vessel. Alternatively, usually just applying firm pressure to the blood vessel for 10 minutes is sufficient as the hole is fairly small. If the puncture site was the wrist then an inflatable compression device is applied for a few hours after.