Although CT and MRI scans can now detect various problems to do with cerebral blood vessels, conventional angiography remains the gold standard and is considered the most sensitive and accurate test for the detection of aneurysms, vascular malformations, and arterial narrowing (stenoses).
Patients lie on the angiography table after which a light sedative can be administered if required. Local anaesthetic is injected around the artery in the groin and a small tube called a catheter is placed into the groin artery. The catheter can be manipulated over a guidewire into the arteries of the neck that supply different parts of the brain, face, scalp, and so on. There is no sensation of the catheter moving within the vessels. With the catheter in position, the arteries are opacified using an X-ray dye or “contrast” which contains iodine. This can cause very brief sensations of warmth over the face or neck, or flashing behind the eye. Some patients have an odd metallic taste. These sensations are normal and typically last about thirty seconds.
You MUST inform us if you have a known allergy to iodine so that preventative medication can be arranged prior to your angiogram.
The X-ray machine will move around you to get different views of your blood vessels. When the procedure is completed, the catheter is removed from your groin and the artery compressed for 10 minutes to limit bruising. Occasionally we may choose to use an artery closure device which avoids the need for compression.
Although we perform many of these procedures on a daily basis and know that the procedure is safe, it does carry a small risk of complications.