Carotid angiography & bull; hello healthy

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Definition

What is carotid angiography?

Carotid angiography is an invasive imaging procedure that involves inserting a catheter into a vein in the arm or leg, and directing it to the carotid artery with the aid of a special X-ray machine. A contrast dye is injected through the catheter so that X-ray images of your carotid arteries (the arteries that supply your brain with oxygen-rich blood) can be taken. This procedure is called the "gold standard" for delineation of the carotids and cerebral blood vessels.

When should I have carotid angiography?

Doctors use carotid angiography to:

• evaluate or confirm a narrowing or blockage in your carotid artery
• determine future stroke risk
• determine the need for further treatment (angioplasty or surgery)
• perform a minimally invasive procedure, carotid stenting, to correct narrowing of the carotid arteries

Precautions & warnings

What should I know before undergoing carotid angiography?

Magnetic resonance angiogram (MRA) or computed tomography angiogram (CTA) can be an option instead of an angiogram. Each of these tests is less invasive than the standard angiogram.

For people who have kidney problems, diabetes, or are dehydrated, steps need to be taken to prevent kidney damage. If you have a history of kidney problems, other blood tests (creatinine, blood urea nitrogen) will be done before having the angiogram to make sure your kidneys are working properly. In rare cases, surgery is needed to repair the hole in the blood vessel where the catheter was placed.

Process

What should I do before undergoing carotid angiography?

Leave all valuables at home. If you normally wear dentures, glasses or hearing aids, don't wear them during the procedure. Your doctor or nurse will give you specific information regarding the foods and drinks you can consume before the procedure. Ask your doctor what medicines you should use on the day of the exam. You may be asked to stop taking certain medications such as Coumadin (warfarin, a blood thinner). If you have diabetes, ask your doctor how the medication you took on the day of the exam was adjusted.

Tell your doctor or nurse if you are allergic to anything especially iodine, shellfish, X-ray dye, latex, or rubber products (such as rubber gloves or balloons).

How is the carotid angiography process?

You will be asked to wear special hospital clothing. The nurse will start by injecting an intravenous (IV) into your arm so that medications and fluids can be given during the procedure.

The temperature in the angiography room is usually cold and the light is dim. You will lie on a special table. When you look up, you will see a large camera and several TV monitors.

The nurse or doctor will clean your skin where the cat (small plastic tube) will be inserted (arm or groin). A sterile curtain is used to cover the area to prevent infection. It is very important to keep your arms and hands on each side and not touching the curtain. Electrodes (small, flat, sticky) will be placed on your chest. The electrodes are connected to an electrocardiograph (EKG) monitor which monitors the electrical activity of your heart.

You may be given a light anesthetic to calm you down, but you will remain conscious throughout the procedure. The doctor will use a local anesthetic to anesthetize the injection site. A plastic sheath (a short, hollow tube in which a catheter is placed) is inserted into a vein in the arm or groin. A catheter will be inserted through the sheath and into your neck arteries (right and left carotid arteries).

Once the catheter is placed, the light will be dimmed and a small amount of "contrast material" will be injected through the catheter into your artery. This contrast material will color the vessels that provide circulation to your brain. An X-ray camera will be used to take pictures of the arteries of the head and neck. You may be asked to hold your breath or turn your head in a different direction when the X-rays are taken. When all the pictures have been taken, the catheter will be removed and the light will come back on.

What should I do after undergoing carotid angiography?

The caterer and casing will be removed. You need to lie down for a few hours. You also need to drink enough fluids to clear the contrast material from your body. You will urinate more often.

If you have questions related to this test process, please consult your doctor for a better understanding.

Explanation of the Test Results

What do my test results mean?

Your doctor will probably tell you about some of your results immediately after the test. The complete test results are usually ready the same day.

Angiogram of the head and neck
Normal:	Normal blood vessels in terms of size, shape, location and number.
The dye flows evenly through the blood vessels.
There was no visible narrowing, blockage, swelling or other problems with the blood vessels.
Abnormal:	Narrowing of the point in the artery can mean the presence of fatty deposits, calcium deposits, or clots that reduce blood flow to the blood vessels.
Abnormal position of the blood vessels, indicating the presence of a tumor or other growth that is encouraging resistance to it.
Swelling of the blood vessels indicates a weakness in the vessel wall (aneurysm).
An abnormal pattern of blood vessels indicates a tumor.
The dye that comes out of the blood vessels indicates a hole in the blood vessel.
The existence of abnormal branching in the blood vessels from birth (congenital).