Carotid Angiography

What is carotid angiography?

Carotid angiography is a procedure in which the doctor examines your carotid artery. This artery in your neck supplies blood to the brain. The doctor uses a catheter (a long flexible tube) to put dye in the artery and takes x-rays to help identify any problems.

When is it used?

This procedure may be done for the following reasons:

to look for blockage or narrowing of the artery.
to look for defects in the artery wall, such as an aneurysm (a weak spot).

The doctor may do a carotid ultrasound first. A carotid ultrasound is a safe, painless procedure in which sound waves are used to create a picture of the artery and its contents. In some cases, the results of the ultrasound eliminate the need to have carotid angiography.

How do I prepare for this procedure?

Before the procedure, tell the doctor if you have had any kidney problems or reactions to iodine-containing substances, such as kidney contrast dye or seafood.

Follow the instructions provided by your doctor. Eat a light meal the night before the test. Do not eat anything after midnight on the day of the procedure, but drink extra water and a sport drink that morning, take your regular medicines except fluid pills (diuretics) and metformin (Glucophage), arthiritis medicine. You probably need premedication with Bicitra and mucomyst. See about a prescription for this. Do not take the metformin (Glucophage) for 2 more days after.

What happens during the procedure?

Before the procedure, a local anesthetic is injected in the area where the catheter will be inserted. Then the doctor inserts a catheter into an artery and guides it to the carotid artery. The doctor puts some dye into this artery and takes an x-ray picture to see if it is blocked or narrowed.

What happens after the procedure?

You may stay under close observation for at least 6 hours. To help control bleeding and heal the artery, a nurse will apply firm pressure to the puncture site for about 20 minutes. He or she will then put an ice pack and a ten-pound sandbag over the area.

Avoid all strenuous activity for the rest of the day. Ask your doctor or nurse for specific instructions on how to care for yourself after you leave the hospital or catheterization lab. Follow your doctor's recommended schedule for your checkup appointment. Ask how and when you should expect to hear your test results.

What are the benefits of this procedure?

This procedure can identify problems in the carotid artery. If problems in the artery are not identified and treated, they could lead to a stroke or sudden death.

What are the risks associated with this procedure?

You may have an allergic reaction to the dye. An allergic reaction may cause difficulty in breathing, a drop in blood pressure, loss of consciousness, or swelling of the skin.
If you have kidney problems, the dye might make them worse. You probably need premedication with Bicitra and mucomyst.
Blood may form a clot around the catheter. This could block the artery and require surgery to reopen it.
The catheter may puncture the artery and cause internal bleeding. Or it may knock some debris off the wall of the artery, causing blockage in another artery in the brain. Surgical correction, if possible, may be necessary.

You should ask your doctor how these risks apply to you.

When should I call the doctor?

Call the doctor immediately if:

You have bleeding where the catheter was inserted.
The area where the catheter was put in swells a lot, especially if the swelling happens in a short time.
You have slurred speech, balance problems, or trouble using your arm or leg.

Call the doctor during office hours if:

You have questions about the procedure or its result.
You need to make your follow-up appointment.