A cerebral angiogram is a minimally invasive diagnostic procedure for clearly visualizing the brain’s vascular system to look for blockages, malformations or bleeding. It can provide a more precise picture of the blood vessels of the brain than other kinds of imaging technique such as MRIs and CAT scans, especially for problems involving very small veins and arteries. In fact, when obtaining an angiogram, the doctor will only see the arteries and veins but not the brain itself. It is the best test that is currently available to evaluate specifically the arteries and the veins of the brain.
An angiogram can help doctors diagnose and plan treatment for conditions such as arteriovenous fistulas and malformations, stenosis (or narrowing) of blood vessels, vasculitis, cerebral aneurysms or certain kinds of very blood supply rich tumors. Without complications, a cerebral angiogram takes around 30 minutes to perform, and full recovery takes about a week. Here’s what to expect at every stage of the process.
Preparing for Your Cerebral Angiogram
Preparing for your angiogram begins several days before your procedure is scheduled. Your doctors will give you specific information on how to get ready for your angiogram, but in general, you can expect to meet with your care team to discuss what will happen and evaluate any ongoing health issues you may have.
If you take any medications, your doctor will review them with you and let you know if there are any you should stop taking before your procedure. Some, such as blood thinning medications like Warfarin (Coumadin®), will need to be stopped several days before your angiogram. If you take insulin for diabetes, your doctor will give you instructions for your dose the day of your procedure.
Depending on circumstances, your doctor may prescribe new medications to take before the procedure. If you have a contrast allergy—an allergic reaction to the kinds of contrast dyes used in imaging procedures—your doctors will prescribe a course of medications including Benadryl® and Medrol to take before the angiogram to ensure your safety.
The contrast dye used in the procedure will need to be flushed from your system through the kidneys, so if you have kidney impairment, your doctor may prescribe a new medication called Mucomyst to take before your procedure and for a couple of days afterward. Be sure to follow all instructions about taking these and any of your usual medications very carefully. If you forget a medication, or make a mistake of any kind, let your doctor know immediately.
As with any surgical procedure, you can expect to be restricted from eating or drinking after midnight before your angiogram. If you do have medications to take the morning of the angiogram, you may be allowed to take them with a small sip of water—but be sure to follow your doctor’s instructions precisely. Chewing gum or a sip of coffee are not allowed.
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Let's find the most appropriate solution to your Cerebrovascular condition.The Day of the Angiogram
On the day of your angiogram, you can expect to spend several hours in the hospital. You’ll be asked to check in a couple of hours before the procedure in order to prepare. During this time, nurses will place an IV and attach stickers for a heart monitor. You may also have blood pressure cuffs placed on your arms.
Before the procedure, your care team will come together to review all the information about your case. To begin, you will be given a sedative and local anesthetics to numb the groin area where the catheter will be inserted. Then, a catheter is threaded through the incision and directed to the area of the brain to be examined. A contrast dye is used to guide the catheter and examine blood flow in the brain via X-ray. Once the imaging is complete, the catheter will be removed and your incision sealed.
Without complications, you can expect to spend four to six hours in the hospital after the angiogram is completed. You will need to lie flat with your leg extended during that time while your care team monitors your angiogram recovery. If all goes well, you’ll be discharged to go home that same day.
Recovering at Home
After leaving the hospital, your recovery continues at home and typically takes about a week. You will be given instructions for caring for your incision and any other information relevant to your individual circumstances, such as how to take any new medications prescribed as part of the procedure and when to resume your usual medications. For the first couple of days, you can expect to be restricted from activities such as climbing stairs, lifting heavy objects, exercise and house chores. You’ll also need to avoid immersing yourself in water—no taking baths or swimming, but you can take a shower the following day after the procedure.
Unless complications occur, you can expect to return to work or school within a couple of days, and gradually resume your full range of normal activities in five to seven days. As you recover, you and your doctors will discuss the information revealed by the angiogram and plan appropriate treatments for your condition.
Preparing for your angiogram and recovery can take a few days, but in general, a cerebral angiogram is a minimally invasive procedure that takes less than an hour and requires less than a day’s stay in the hospital. And unless you have other health conditions to consider, you can expect to be back to your normal activities in about a week. Your doctors will work with you to develop a recovery timeline that fits your unique circumstances.
About Dr. Dorothea Altschul
Dr. Dorothea Altschul is an accomplished neurointerventionalist in North Jersey and is the Clinical Director of Endovascular Services at Neurosurgeons of New Jersey, practicing out of their Ridgewood office located on East Ridgewood Avenue.
