Angiogram of the Head and Neck
An angiogram of the head and neck is an X-ray test that uses a special dye and camera (fluoroscopy) to take pictures of the blood flow in the blood vessels of the head and neck. An angiogram of the neck (carotid angiogram) can be used to look at the large arteries in the neck that lead to the brain. An angiogram of the head (cerebral angiogram) can be used to look at the veins or the four arteries (four-vessel study) carrying blood to the brain.
During an angiogram, a thin, soft tube called a catheter is placed into a blood vessel in the groin (femoral artery or vein) or just above the elbow (brachial artery or vein). The catheter is guided to the head and neck area. Then an iodine dye (contrast material) is injected into the vessel to make the area show clearly on the X-ray pictures. The angiogram pictures can be made into regular X-ray films or stored as digital pictures in a computer.
An angiogram can find a bulge in a blood vessel (aneurysm). It can also show narrowing or a blockage in a blood vessel that slows or stops blood flow. An abnormal pattern of blood vessels (arteriovenous [AV] malformation) or abnormal vessels near a tumor can be seen.
A magnetic resonance angiogram (MRA) or computed tomography angiogram (CTA) may be an option instead of a standard angiogram. Each of these tests is less invasive than an angiogram. Some MRA tests and all CTA tests require an injection of dye. A CTA also involves radiation exposure.
Why It Is Done
An angiogram of the head or neck is done to:
How To Prepare
Before an angiogram, tell your doctor if you:
Do not eat or drink for 4 to 8 hours before the angiogram. You may be asked to not take aspirin, aspirin products, or blood thinners for several days before the test and for 1 day after the test. If you take these medicines, talk with your doctor.
An angiogram can be done as an inpatient or outpatient. If you are an outpatient, you will stay in a recovery room for several hours before you go home. You may want to bring something to do or read to pass the time. Arrange to have someone take you home because you may get a sedative before the test. If you stay overnight in the hospital, you will likely go home the next day.
The test may take several hours, so you will empty your bladder just before it begins.
Also before the angiogram you may have other blood tests, such as blood clotting (coagulation) studies, blood urea nitrogen (BUN), and creatinine.
You will be asked to sign a consent form that says you understand the risks of the test and agree to have it done.
Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results will mean. To help you understand the importance of this test, fill out the medical test information form(What is a PDF document?).
How It Is Done
You will need to take off any jewelry. You may need to take off all or most of your clothes. You will be given a gown to wear during the test.
During the test
You will likely have an intravenous (IV) line in a vein in your arm so your doctor can give you medicine or fluids if needed. A device called a pulse oximeter, which measures oxygen levels in your blood, may be clipped to your finger or ear. Small discs (electrodes) are placed on your arms, chest, or legs to record your heart rate and rhythm.
You will lie on your back on an X-ray table. Ask for a pad or blanket to make yourself comfortable. A strap, tape, or sandbags may be used to hold your body still. A lead apron may be placed under your genital and pelvic areas to protect them from X-ray exposure.
A round cylinder or rectangular box that takes the pictures during fluoroscopy will be moved above you. The fluoroscope will move under you during the test.
The place where the catheter will be inserted (in the groin or above the elbow) will be shaved and cleaned. Your doctor will numb the area with a local anesthetic. Then he or she will put a needle into the blood vessel. A guide wire will be put through the needle into the blood vessel and the needle will be removed. The catheter then will be placed over the guide wire and moved into the blood vessel. The catheter will be guided through the blood vessels until the tip is in the area to be studied. Your doctor will use the fluoroscope to watch the movement of the catheter in the blood vessels.
When the catheter is in place, the dye is injected through it. You may be asked to take a breath and hold it for several seconds. Several X-ray pictures will be taken one after another. These will be available right away for your doctor to look at. You need to lie very still so the pictures are clear. More pictures may be taken.
An angiogram takes 1 to 3 hours.
After the test
The catheter is taken out after the angiogram, and pressure is put on the needle site for 10 to 15 minutes to stop any bleeding. A small sandbag or clamp may be put on the site to hold pressure. A bandage is put on the site. You will be given pain medicine if you need it.
If the catheter was put in a vessel in your arm, you should not have any blood taken from that arm or your blood pressure measured in that arm for several days. You will rest in bed after the test for several hours. If the catheter was placed in the groin area, try to keep that leg straight for 8 hours. Your doctor will give you specific instructions after the test. You can use an ice pack on the needle site to relieve pain and swelling.
The place in your hands and feet where your heartbeat (peripheral pulse) can be felt may be marked with a pen. Your pulse may be checked before and after the angiogram.
How It Feels
You may feel a brief sting or pinch from the numbing medicine. Most people do not have pain when the catheter is in the blood vessel.
You may feel pressure in the blood vessel as the catheter is moved. Let your doctor know if you are having pain.
You will probably feel some warmth when the dye is put in. This feeling lasts only a few seconds. For some people, the feeling of heat is strong and for others it is very mild.
You may have a headache, flushing of the face, or a salty or metallic taste in your mouth after the dye is used. These feelings do not last long. Some people may feel sick to their stomachs or may vomit, but this is not common.
After the test, you may have some tenderness and bruising at the site where the catheter was inserted.
You can drink extra fluids to pass the dye from your body unless your doctor has told you not to.
The chance of any major problem from an angiogram is very small, but some problems can occur. In most cases, the problems occur within 2 hours after the test when you are in the recovery room. If the problem occurs during the angiogram, the test may not be completed. You may need urgent treatment that could include surgery.
Angiogram of the head and neck is an X-ray test that uses a special dye and camera (fluoroscopy) to take pictures of the blood flow in the blood vessels of the head and neck. Your doctor may tell you some results right after the test. Full results are usually ready the same day.
What Affects the Test
Reasons you may not be able to have the test or why the results may not be helpful include:
What To Think About
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