5- Cerebral angiography

Definition: Cerebral angiography is a diagnostic procedure that uses X-rays and

contrast dye to visualize the blood vessels in the brain. It provides detailed
images of the blood flow within the arteries and veins of the brain, helping to
identify abnormalities such as aneurysms, arteriovenous malformations, or
blockages.
Purpose/Reasons: Cerebral angiography is performed to diagnose various conditions
affecting the blood vessels in the brain, including aneurysms, tumors, vascular
malformations, and narrowing or blockages in the arteries. It helps in planning
treatments such as embolization, stenting, or surgery.
List of Objectives:
1. To visualize the blood vessels in the brain.
2. To identify abnormalities such as aneurysms or arteriovenous
malformations.
3. To assess blood flow within the arteries and veins of the brain.
4. To guide treatment decisions for vascular conditions.
Step by Step Before Procedures with Rationale:
1. Patient Preparation: Explain the procedure to the patient to ensure
understanding and cooperation.
• Rationale: Informed consent is essential for patient safety and
compliance.
2. Medical History Review: Assess the patient’s medical history,
allergies, and current medications.
• Rationale: To identify any potential risks or contraindications before
the procedure.
3. NPO Status: Instruct the patient to fast for a certain period before
the procedure.
• Rationale: To reduce the risk of aspiration during sedation or
anesthesia.
4. IV Line Insertion: Establish intravenous access for contrast dye
administration.
• Rationale: Facilitates rapid delivery of medications and contrast dye
during the procedure.
Materials/Equipment Needed:
1. X-ray machine
2. Contrast dye
3. Catheters
4. Guidewires
5. Sedatives/anesthetics
6. Monitoring equipment (ECG, blood pressure cuff)
Step by Step During Procedures with Rationale:
1. Anesthesia/Sedation: Administer sedatives or anesthesia to ensure
patient comfort and cooperation.
• Rationale: Minimize discomfort and anxiety during the invasive
procedure.
2. Catheter Insertion: Insert a catheter into a blood vessel in the groin
or wrist and advance it towards the carotid or vertebral artery.
• Rationale: Allows access to inject contrast dye directly into the
cerebral vessels for imaging.
3. Contrast Dye Injection: Inject contrast dye while capturing X-ray
images to visualize blood flow in real-time.
• Rationale: Enhances visibility of blood vessels and abnormalities on X-
ray images.
4. Image Acquisition: Obtain multiple X-ray images from different angles
to capture a comprehensive view of cerebral vasculature.
• Rationale: Ensures accurate assessment of blood flow dynamics and
vascular anatomy.
Step by Step After Procedures with Rationale:
 1. Post-Procedure Monitoring: Monitor vital signs and neurological status
post-procedure.
• Rationale: Detect any immediate complications such as bleeding or
stroke promptly.
2. Patient Recovery: Ensure adequate hydration and monitor for any signs
of allergic reactions to contrast dye.
• Rationale: Prevent dehydration and manage potential adverse reactions
effectively.

1. Mayo Clinic
2. RadiologyInfo.org
3. American College of Radiology (ACR)