Angiography

An angiography is done to examine or treat the blood vessels which supply blood to your head, neck or spine. You will be under the care of a Johns Hopkins neuroradiologist (a physician trained and experienced in this specialty) and a dedicated team of health care professionals. We are leaders in the prevention, diagnosis, and treatment of neurovascular problems, and utilize state of the art equipment in performing these procedures.

How to Prepare

If you are an outpatient, a Radiology staff member will call you several days before your procedure to review your preparations and answer any questions. You may also call (410)955-8525 to address any concerns you have about your procedure. If you are an inpatient, one of our staff will visit you the night before your procedure.

Please notify us several days prior to your procedure if:

• You have allergies to x-ray contrast (dye) or iodine
• You have a history of asthma or kidney disease
• You take insulin, oral hypoglycemics (for diabetes) such as glucophage, or blood thinners such as Coumadin, Persantine or Aspirin
• You are, or suspect you are, pregnant

Take your medications as usual, unless told not to do so by your physician. Do not eat solid food within eight hours of your procedure. If you are to receive general anesthesia for your procedure, you must not have food or drink after midnight the night before your procedure.

If you are an outpatient and you are to receive general anesthesia, you will be scheduled for a "pre-anesthesia" physical within a 2-week period prior to your procedure. If you are an inpatient, the anesthesiologist will visit you the evening before your procedure.

Remove all your jewelry before coming to your appointment, as you will not be able to store your valuables at the hospital while having your procedure performed.

If you are an outpatient, please arrange for someone to drive you home after the procedure.

Bring the following paperwork with you to your appointment:

• Any existing CT, MRI, myelogram, and angiogram films and reports. If you have had a prior arteriogram, bring those films or arrange to have them sent to us in advance of your test.
• Information about existing conditions and medications.
• Appropriate medical insurance materials.

Neuroangiography procedures are very safe. However, very rarely one may experience an allergic reaction to the dye, damage or blockage to a blood vessel, or bleeding. We will review these risks in detail you will be asked to sign a consent form before your angiography that will detail the risks and side-effects associated with the procedure.

What to Expect

An intravenous line will be started in your arm to give you fluids and medications to relax you if you require them. You will be taken to the procedure room, where you will lie on your back during your angiogram. Cushions and pillows will be used to make you comfortable. The skin where the catheter will be inserted, which is usually in the upper thigh-groin region, will be cleansed, and you will be covered from the shoulders down with a sterile drape.

The neuroradiologist will give you local anesthetic in your groin which may cause slight discomfort for a few seconds before going numb. A catheter will be inserted through a small incision in the skin, which will be guided into the vessels to be examined. You will feel minimal pressure in the area. 

When the neuroradiologist has placed the catheter in the correct position, a contrast dye will be injected which may cause a warm, but not painful, feeling for a few seconds. During this time, you will also hear an x-ray machine taking pictures. It is important to remain still, without breathing or swallowing, while the dye is injected and the pictures are taken. Please tell the nurse who will be present through your procedure if you become uncomfortable.

In general, diagnostic procedures require about two hours; therapeutic procedures typically require more. When your procedure is completed, pressure will be applied to the incision site for 10-20 minutes after which a small bandage will be placed over the incision. No stitches will be required. You will then need to lie on your back with your leg straight and still for four to six hours. A meal will be provided during this time.

If you are an outpatient, you will be observed in the Neuroangiography area. You may bring reading material or other items to pass the time. Friends or family members may visit as desired. You will be discharged by us when it is safe for you to leave, usually between 6 and 8 hours after your study. Written instructions for home care will be provided. If necessary, you may be admitted to the hospital after your procedure.

If you are an inpatient, you will be returned to your room for observation by your floor nurse.

The neuroradiologist will communicate the results of your examination to your physician, who will discuss the results with you at an appropriate time. The referring physicians often prefer that we refrain from discussing the findings with the patients, particularly before they have been notified.

Precautions After Your Procedure

You may resume your usual diet after the procedure. We recommend that you drink about 48-64 ounces of fluids during the next 24 hours as this aids in eliminating the injected x-ray dye.

Do not exert yourself for 24 hours following the procedure. If you are an outpatient, a family member or friend should drive you home and stay with you during the 24-hour period.

It is not unusual to have minor bruising around the incision, but if you experience bleeding or swelling there, or develop a cold or painful leg, contact us immediately.

We call our outpatients and visit inpatients the day after the procedure. 

Additional Information

For additional information on the web, we recommend you click on the link below to visit the ACR and RSNA patient information site:  http://www.radiologyinfo.org/