An angiogram of the head and neck is an
X-ray test that uses a special dye and camera (fluoroscopy) to take pictures of the blood flow in the blood vessels of the head and neck. An angiogram of the neck (carotid
angiogram) can be used to look at the large arteries in the neck that lead to
the brain. An angiogram of the head (cerebral angiogram) can be used to look at
the veins or the four arteries (four-vessel study) carrying blood to the
During an angiogram, a thin, soft tube called a catheter is
placed into a blood vessel in the groin (femoral artery or vein) or just above
the elbow (brachial artery or vein). The catheter is guided to the head and
neck area. Then an iodine dye (contrast material) is injected into the
vessel to make the area show clearly on the X-ray pictures. The angiogram
pictures can be made into regular X-ray films or stored as digital pictures in
An angiogram can find a bulge in a blood vessel (aneurysm). It can also show narrowing or a blockage in
a blood vessel that slows or stops blood flow. An abnormal pattern of blood
vessels (arteriovenous [AV] malformation) or abnormal vessels near a tumor can
magnetic resonance angiogram (MRA) or
computed tomography angiogram (CTA) may be an option
instead of a standard angiogram. Each of these tests is less invasive than an
angiogram. Some MRA tests and all CTA tests require an injection of dye. A CTA
also involves radiation exposure.
An angiogram of the head or neck is
Before an angiogram, tell your doctor
Do not eat or drink for 4 to 8 hours before the angiogram.
You may be asked to not take aspirin, aspirin products, or blood thinners for
several days before the test and for 1 day after the test. If you take these
medicines, talk with your doctor.
An angiogram can be done as an
inpatient or outpatient. If you are an outpatient, you will stay in a recovery
room for several hours before you go home. You may want to bring something to
do or read to pass the time. Arrange to have someone take you home because you
may get a
sedative before the test. If you stay overnight in the
hospital, you will likely go home the next day.
The test may take
several hours, so you will empty your bladder just before it begins.
Also before the angiogram you may have other blood tests, such as blood
clotting (coagulation) studies, blood urea nitrogen (BUN), and
You will be asked to sign a consent form that says you understand the risks of the test and agree to have it done.
your doctor about any concerns you have regarding the need for the test, its
risks, how it will be done, or what the results will mean. To help you
understand the importance of this test, fill out the
medical test information form(What is a PDF document?).
An angiogram can be done by different types of doctors, including a
radiologist, cardiologist, or surgeon. Your doctor may be helped by a radiology technologist or a nurse.
You will need to
take off any jewelry. You may need to take off all or most of your clothes. You
will be given a gown to wear during the test.
You will likely have
intravenous (IV) line in a vein in your arm so your
doctor can give you medicine or fluids if needed. A device called a pulse
oximeter, which measures oxygen levels in your blood, may be clipped to your
finger or ear. Small discs (electrodes) are placed on your arms, chest, or legs
to record your heart rate and rhythm.
You will lie on your back on
an X-ray table. Ask for a pad or blanket to make yourself comfortable. A strap,
tape, or sandbags may be used to hold your body still. A lead apron may be
placed under your genital and pelvic areas to protect them from X-ray
A round cylinder or rectangular box that takes the
pictures during fluoroscopy will be moved above you. The fluoroscope will move
under you during the test.
The place where the catheter will be
inserted (in the groin or above the elbow) will be shaved and cleaned. Your
doctor will numb the area with a
local anesthetic. Then he or she will put a needle
into the blood vessel. A guide wire will be put through the needle into the
blood vessel and the needle will be removed. The catheter then will be placed
over the guide wire and moved into the blood vessel. The catheter will be
guided through the blood vessels until the tip is in the area to be studied.
Your doctor will use the fluoroscope to watch the movement of the catheter in
the blood vessels.
When the catheter is in place, the dye is
injected through it. You may be asked to take a breath and hold it for several
seconds. Several X-ray pictures will be taken one after another. These will be
available right away for your doctor to look at. You need to lie very still so
the pictures are clear. More pictures may be taken.
An angiogram takes 1 to 3 hours.
catheter is taken out after the angiogram, and pressure is put on the needle
site for 10 to 15 minutes to stop any bleeding. A small sandbag or clamp may be
put on the site to hold pressure. A bandage is put on the site. You will be
given pain medicine if you need it.
If the catheter was put in a
vessel in your arm, you should not have any blood taken from that arm or your
blood pressure measured in that arm for several days. You will rest in bed
after the test for several hours. If the catheter was placed in the groin area,
try to keep that leg straight for 8 hours. Your doctor will give you specific
instructions after the test. You can use an ice pack on the needle site to
relieve pain and swelling.
The place in your hands and feet where
your heartbeat (peripheral pulse) can be felt may be marked with a pen. Your
pulse may be checked before and after the angiogram.
You may feel a brief sting or pinch from
the numbing medicine. Most people do not have pain when the catheter is in the
You may feel pressure in the blood vessel as the
catheter is moved. Let your doctor know if you are having pain.
You will probably feel some warmth when the dye is put in. This feeling
lasts only a few seconds. For some people, the feeling of heat is strong and
for others it is very mild.
You may have a headache, flushing of
the face, or a salty or metallic taste in your mouth after the dye is used.
These feelings do not last long. Some people may feel sick to their stomachs or
may vomit, but this is not common.
After the test, you may have
some tenderness and bruising at the site where the catheter was
You can drink extra fluids to pass the dye from your
body unless your doctor has told you not to.
The chance of any major problem from an
angiogram is very small, but some problems can occur. In most cases, the
problems occur within 2 hours after the test when you are in the recovery room.
If the problem occurs during the angiogram, the test may not be completed. You
may need urgent treatment that could include surgery.
Angiogram of the head and neck is an
X-ray test that uses a special dye and camera (fluoroscopy) to take pictures of the blood flow in the
blood vessels of the head and neck. Your doctor may tell you some results right
after the test. Full results are usually ready the same day.
The blood vessels are normal
in size, shape, location, and number.
The dye flows evenly through
the blood vessels.
No narrowing, blockage,
bulging, or other problem of the blood vessels is seen.
A narrow spot in an artery
may mean that a fat deposit, calcium deposit, or clot is reducing blood
flow through the blood vessel.
Blood vessels that are not in
their normal position may mean that a tumor or other growth is pushing
A bulge in a blood vessel may
point to a weakness in the blood vessel wall (aneurysm).
An abnormal pattern of blood
vessels may mean that a tumor is present.
that leaks out of a blood vessel may mean that
there is a hole in the blood vessel.
There is abnormal branching of
blood vessels present since birth (congenital).
Reasons you may not be able to
have the test or why the results may not be helpful include:
Other Works Consulted
Chernecky CC, Berger BJ (2008). Laboratory Tests and Diagnostic Procedures, 5th ed. St. Louis: Saunders.
Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.
Pagana KD, Pagana TJ (2010). Mosby’s Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis: Mosby Elsevier.
November 27, 2012
Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
& Howard Schaff, MD - Diagnostic Radiology
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