Carotid angiography is an invasive imaging procedure that involves inserting a catheter into a blood vessel in the arm or leg and guiding it to the carotid arteries with the aid of a special x-ray machine.
Contrast dye is injected through the catheter so that x-ray movies of your carotid arteries (the arteries that supply your brain with oxygen-rich blood) are taken.
This procedure is considered the “gold standard” for imaging the carotid and cerebral vessels.
Your doctor uses carotid angiography to:
- Evaluate or confirm the presence of narrowing or blockage in your carotid arteries
- Determine risk for future stroke
- Determine the need for further treatment (angioplasty or surgery)
- Perform a minimally invasive procedure, carotid stenting, to fix the narrowing in the carotid artery
What is involved with this procedure?
Before a scheduled carotid angiogram, your doctor reviews your medical history and performs a physical exam. You may also have one or more of the following examinations:
- Ultrasound. A scanner passes over the carotid artery to produce images using sound waves of the narrowed artery and of the blood flow to the brain.
- Magnetic resonance angiography (MRA) or computerized tomography angiography (CTA). These exams provide highly detailed images of blood vessels by using either radiofrequency waves in a magnetic field or by using X-rays with contrast material.
You’ll receive instructions on what you can or can’t eat or drink before your procedure.
The night before your procedure:
- Follow your doctor’s instructions about adjusting your current medications. Your doctor may instruct you to stop taking certain medications before angioplasty, particularly if you take certain diabetes medications or blood thinners.
- Take approved medications with only small sips of water.
- Arrange for transportation home. You won’t be able to drive yourself home because of lingering effects of the sedative.
Before the procedure
- Your groin or wrist is shaved and prepared with antiseptic solution, and a sterile drape is placed over your body.
- A local anesthetic is injected into the area to numb the area.
- You will be given a sedative through your IV to help you relax and make you sleepy. We will need you somewhat awake to follow instructions, like holding your breath and to not swallow.
During the procedure
- A small tube (sheath) is placed into the artery. A catheter is threaded through the tube. You won’t feel the catheter passing through the arteries because the insides of arteries don’t have nerve endings – otherwise you would feel your blood going through your body!
- Contrast material is injected into the carotid artery through the catheter. The contrast material may cause a temporary warm feeling on one side of your face. Contrast dye provides a detailed view of the narrowed artery and blood flow to the brain.
When the procedure is completed, the site where the catheter was inserted is closed a few different ways:
- Pressure is applied to the groin site to stop bleeding.
- A “collagen plug” is inserted into the groin area to stop bleeding.
- Pressure is applied to your wrist to stop bleeding.
- You’ll then be taken to the recovery area.
After the procedure
To avoid bleeding from the catheter insertion site, you need to lie relatively still or keep your wrist straight for several hours in the recovery area. The catheter site may remain tender, swollen and bruised for a few days. There may be a small area of discoloration or a small lump in the area of the puncture.
You may take acetaminophen (Tylenol, others) in the recommended dose as needed for discomfort, or other medication as prescribed by your doctor.
You may need to avoid strenuous activity and heavy lifting for 24 hours after the procedure.
The physician will go over the results we found on your angiogram. Based on the angiogram findings, decisions will be discussed how to proceed further.
Carotid Angiograms at San Tan Cardiovascular Center
At San Tan Cardiovascular Center, we have a state-of-the-art angiography suite in our Gold Canyon location that is the same system used in most hospitals across the Valley. This specialized equipment produces superior, high quality images that give accurate results for our patients.
Our highly experienced staff will be happy to care for you during your outpatient procedure. You can feel confident you will receive quality care in our outpatient lab due to our one-on-one patient care approach.
How do I get started?
Contact San Tan Cardiovascular Center today to make an appointment with one of our healthcare providers.
At this appointment:
- we will review your medical history, discuss your symptoms and perform a non-invasive, diagnostic test to further determine your medical condition,
- any pertinent testing that needs to be done beforehand will also be ordered at this time.
Our billing department will then contact your health insurance company to obtain prior authorization. Upon receiving insurance authorization, the procedure will be scheduled.
Carotid Angiogram FAQs
Q: What are the risks of carotid angiograms?
A: With any medical procedure, complications might happen. Here are some of the possible complications of carotid angioplasty and stenting:
- Stroke or mini-stroke (transient ischemic attack, or TIA). During angiograms, blood clots may form on the catheters and can break loose and travel to your brain. A stroke can also occur if plaque in your artery is dislodged when the catheters are being threaded through the blood vessels.
- New narrowing of the carotid artery (restenosis).A major drawback of carotid angioplasty is the chance that your artery will narrow again within months of the procedure. Special drug-coated stents have been developed to reduce the risk of restenosis.
- Blood clots.Blood clots can form within stents even weeks or months after angioplasty. These clots may cause a stroke or death. It’s important to take aspirin, clopidogrel (Plavix) and other medications exactly as prescribed to decrease the chance of clots forming in your stent.
- You may have bleeding at the site in your groin or wrist where the catheter was inserted. Usually this simply results in a bruise, but sometimes serious bleeding occurs and may require a blood transfusion or surgical procedures.
Q: How can I prevent possible carotid artery problems?
A: Lifestyle changes will help you maintain your good results:
- Don’t smoke.
- Lower your cholesterol and triglyceride levels.
- Maintain a healthy weight.
- Control other conditions, such as diabetes and high blood pressure.
- Exercise regularly.