From this article you will learn: what is angiography of cerebral vessels, what diseases can be identified with its help, how to prepare for it. Procedure, contraindications and complications.
Article content:
- Indications for angiography of cerebral vessels
- How to prepare?
- How is the procedure performed?
- Possible complications
- Contraindications
Angiography of vessels in the brain is a diagnostic procedure that allows you to assess the condition of the arteries and veins of this brain.
There are three types of angiography:
- X-ray angiography is performed using an apparatus that radiates X-ray waves. To make the pictures show the vessels, the patient is administered a contrast agent based on iodine.
- MR angiography is the study of cerebral vessels with the help of a magnetic resonance tomograph. This method usually does not involve the administration of contrast media. However, contrast preparations based on gadolinium can be used to obtain particularly detailed images.
- CT angiography is a diagnostic procedure that allows obtaining a detailed three-dimensional image of blood vessels using a computer tomograph. X-ray waves are also used. The data from the tomograph is processed by a computer, as a result of which the specialist receives a detailed layered image of the vessels. When CT angiography is also used iodine-containing contrast agent.
Angiography of vessels with the help of the X-ray device 
Angiography with magnetic resonance tomograph 
Angiography using a computer tomograph The most accurate method is CT angiography.
The procedure itself is performed by an angiographic doctor. Deciphering angiography deals with a neurosurgeon, angiosurgeon or phlebologist.
Indications for
Angiography of cerebral vessels is performed if the patient is concerned about such symptoms:
- frequent attacks of headaches;
- dizziness;
- noise or ringing in the ears;
- pain and stiffness in the cervical spine;
- reduced pressure;
- nausea;
- recurrent syncope.
Symptoms in which angiography is prescribed Angiography can reveal:
- narrowing of the lumen or obstruction of vessels by an atherosclerotic plaque or thrombus;
- vasospasm;
- inflammation of the vessel walls;
- pathological crimp;
- aneurysms( protrusion of the artery wall);
- malformation( connections between arteries and veins, which should not normally be);
- damages the walls of the vessels that lead to hemorrhages.
Also with the help of angiography it is possible to diagnose tumors in the hemispheres and the Turkish saddle: with neoplasms, cerebral vessels are displaced, and new small vessels are formed that grow into the tumor.
How to prepare for angiography?
It is best to go to the procedure in the morning on an empty stomach, as you can not eat 8-10 hours before angiography.
If you are taking medication at the time of diagnosis, tell your doctor. He can decide to cancel the drug on the day of angiography.
Before the procedure, you will be allergic to a contrast agent. For this, a small dose of the drug will be administered intravenously. If no signs of an allergy appear within half an hour, angiography can be performed. If symptoms such as a rash, swelling, nausea, dizziness, runny nose and dry cough appear, then you are allergic to a contrast agent. In this case, only MR angiography can be performed without a contrast agent.
Immediately before angiography you will be asked to remove all metal jewelry, as well as dentures, if any, and put on a special hospital gown.
How is the procedure performed?
Before the angiography of the cerebral vessels, you will be given a contrast agent. Do this with a catheter - a special plastic tube. Depending on which vessels should be examined, the drug can be injected into different places. If it is necessary to conduct a survey of all the vessels of the brain - the catheter is brought to the aortic arch. If partial diagnostics are required - the catheter can lead to the vertebral vertebra or carotid artery.
The catheter is always fed through smaller, peripheral arteries, for example, the elbow or femoral. A needle can be used instead of a catheter. Catheterization or puncture is performed under local anesthesia.
Procedure for angiography of cerebral vessels During the injection of contrast medium, you can feel a burning sensation, a flush of heat, a metallic or salty taste in your mouth. A face may turn red. These symptoms usually last for a minute.
Further, depending on the type of angiography, you lie on the table of a computer, magnetic resonance tomograph or an X-ray machine. You will be asked to lie motionless until the end of the procedure.
The whole process( together with catheterization) takes about an hour. Pictures are shown immediately during the procedure. If they are unsatisfactory in quality, an additional dose of contrast medium may be administered to the patient.
After the angiography, you will be under the supervision of a doctor for 5-6 hours. He will see to it that complications do not develop, and also to observe the condition of the artery, into which the catheter or needle was inserted. If the catheterization is through the femoral artery, the doctor will recommend that you do not bend the leg for 6 hours after angiography.
Possible complications of
After angiography of the cerebral vessels, the side effects of the contrast agent may appear:
- nausea and vomiting,
- rash,
- arrhythmia,
- chills,
- low blood pressure,
- kidney disorders.
Within 6-8 hours after the diagnostic examination, the doctor observes that strong side effects do not develop, and conducts symptomatic treatment if necessary.
There may also be complications associated with catheterization or puncture. This can be a bruise in the puncture area - in this case, no special treatment is required. A more serious complication that occurs rarely is the formation of a blood clot in the vessel that was used for catheterization.
Who should not do angiography?
Angiography of cerebral vessels has a number of contraindications. They depend on the type of procedure.
Contrast agent is contraindicated when:
- severe kidney and liver disease;
- allergies to iodine-containing drugs;
- bronchial asthma;
- severe heart disease.
With great care is used in the elderly and senile age.
Contraindications for different types of angiography
| type | procedure Contraindications |
|---|---|
| X-ray, CT angiography | Acute infectious diseases |
| Idiosyncrasy contrast agent | |
| Type 2 diabetes | |
| Pregnancy | |
| Multiple myeloma | |
| Pathology thyroid | |
| Severe liver disease, heart or kidney | |
| MR- angiography | The patient has a pacemaker, electronic or ferromagnetic implants of the middle ear,vayuschih clips cerebrovascular |
| Heart failure | |
| Pregnancy. |
CT and MR angiography can not be carried to a patient weighing more than 120 kg, since the tomograph simply is not designed for such dimensions.
Relative contraindication for CT and MR angiography - claustrophobia. Patients with fear of confinement, it can be conducted under general anesthesia. Also, general anesthesia is also used in severe mental disorders, which do not allow a full diagnostic procedure.
