Cerebral angiography involves the injection of an iodine-based contrast agent (“dye”) into an artery directly leading to the brain via a catheter (a small tube).
The catheter is usually advanced into the arterial system via the femoral artery (the artery going down to the leg) or radial artery (one of the two arteries going to the hand). Accessing the artery is done under local anaesthetic, and can be a little uncomfortable, but is usually very well tolerated. There is no sensation of any movement of the catheter inside the body.
During the injection of X-ray dye it is not uncommon to feel a warm sensation in the face or neck and some people describe seeing flashes or lines during the injection. These sensations are not harmful and resolve rapidly (within 20 seconds) after each injection of X-ray dye.
Before taking the pictures the radiographer will ask you to keep very still and hold your breath so that the pictures are not blurred. This is very important.
The procedure is similar to angiography performed in other parts of the body, the difference is that the brain is less tolerant than any other part of the body.
NIISwa Interventional Neuroradiologists perform all cerebral angiography in Western Australia, thus maintaining a frequent practice and a large body of experience, minimizing the risk of complications. However, although we perform hundreds of these procedures a year and we know from experience that the procedure is very safe, rarely complications can occur. These include stroke, arterial damage (dissection), access complications requiring further treatment, kidney impairment and allergic reactions to the contrast.
Following the procedure the catheters are removed and the artery may be sealed by a small device or by manual compression for around 10 minutes. You will then be instructed to keep your leg straight and lie relatively flat for around 4-6 hours allowing the artery to form a seal.