ANGIOGRAPHY - CERVICAL, CEREBRAL AND SPINAL

 Cerebral Angiography is a type of imaging of the blood-vessels. 

Due to the resolution obtained during the scan, it is considered the Gold standard test to diagnose any blood vessel related disorders in the brain.

When Angiography is done on Brain's blood vessels, it is called a Cerebral Angiogram. 

When Angiography is done on Spinal cord's blood vessels, it is called a Spinal Angiogram. 

A peripheral artery such as Femoral artery or Radial artery is accessed and a catheter is taken under X-ray guidance up to the blood vessels of interest.

After this, X-ray is turned on while simultaneously injecting contrast or "dye" from the catheter into the artery. 

The resulting Angiographic picture is the most accurate way of looking at arteries in the neck, head and brain, and it provides information that cannot be obtained with other tests. 

A trained specialist can perform a Cerebral Angiogram with complication rate of less 5 in 1000 cases.

The main complications are infections, bleeding complications, strokes. 

Other side effects can include radiation exposure, kidney injury from the contrast, injury to surrounding tissue while gaining access to the blood vessel etc.

All the possible complications and risks should be discussed by the clinician and the benefits outweighed before performing the Angiogram.

 A Neurologist, Neurosurgeon or a Neuro radiologist trained in Endovascular Neurosurgery/Interventional Neurology/Interventional Neuroradiology can safely perform Cerebral and Spinal Angiogram and other Angiographic interventions. 

Post operative period varies widely depending on the type of procedure.

For an elective diagnostic cerebral angiogram performed through the Femoral artery (artery in the groin), the patient is usually observed for about 6 hours post procedure and discharged home if no complications.

For an elective diagnostic angiography through the radial artery (artery in the wrist) route, patients can be discharged home within an hour or two after the procedure. 

For elective treatments/interventions, patients are typically observed overnight and discharged the next day if no complications.

Radial artery access from the wrist or the Anatomical snuff box is being realized as an elegant and patient friendly approach, especially if ultrasound guidance is used. 

Some training programs have started incorporating radial artery access for their fellows in training.

You can check with your clinician if a radial artery access is feasible.

In our experience- most, if not all of the diagnostic procedures and most of the interventions can be safely performed through the radial artery route.