Spinal angiography
What is a spinal angiogram?
A spinal angiogram is a specialised X-ray test that provides detailed images of the blood vessels supplying the spinal cord. It involves inserting a thin tube (catheter) into an artery, usually in the groin, and navigating it to the arteries that feed the spine. An iodine-based dye (contrast) is then injected through the catheter to make the vessels visible on X-rays.
Why is spinal angiography performed?
Spinal angiography is most often carried out to diagnose and assess:
- Spinal arteriovenous malformations (AVMs)
- Dural arteriovenous fistulas (dAVFs)
- Spinal tumours with abnormal blood supply
- Vascular causes of spinal cord injury or bleeding
It is also used to guide treatment planning and to confirm successful therapy after an intervention.
What are the risks of spinal angiography?
Spinal angiography is generally safe when performed by experienced specialists, but as it involves introducing a catheter into the arteries and injecting contrast dye, there are some specific risks to be aware of.
Common but usually minor risks:
- Bruising or soreness at the catheter insertion site (usually in the groin).
- Temporary pain or warmth when the contrast dye is injected.
- Allergic reaction to the contrast dye, which is usually mild (for example, a rash or itching).
Uncommon but more serious risks:
- Arterial injury or blockage. The catheter can occasionally damage a vessel or cause a small clot, potentially affecting blood flow.
- Spinal cord ischaemia. Very rarely, the blood supply to the spinal cord can be affected, leading to weakness, numbness, or paralysis. This is the most serious potential complication, though it occurs in less than 1 in 1,000 cases in specialist centres.
- Contrast-induced kidney injury. The iodine-based dye can temporarily affect kidney function, particularly in people with pre-existing kidney disease.
- Infection or bleeding at the puncture site, which is uncommon and usually minor.