CEREBRAL

ANGIOGRAPHY
What is Cerebral Angiography?
What are some common
uses of the procedure?
A cerebral angiogram may be
performed:

• To evaluate arteries of the head and neck

before surgery.
• To provide additional information on
abnormalities seen on MRI or CT of the head.
• To prepare for other medical treatment.
• In preparation for minimally invasive
(endovascular) treatment.
The procedure is also used to help
diagnose the cause of symptoms such as:
• Severe headaches
• Memory loss
• Slurred speech
• Dizziness
• Blurred or double vision
• Weakness or numbness
• Loss of coordination or balance
How should I prepare?
⮚You should report to your doctor all
medications that you are taking including
herbal supplements, and if you have any
allergies, especially to local anesthetic
medications, general anesthesia or contrast
materials containing iodine (sometimes
referred to as “dye” or “x-ray dye”)
⮚Your physician may advise you top stop taking
aspirins, nonsteroidal anti-inflammatory drugs
(NSAIDs) or blood thinners for a specified
period of time before your procedure.
⮚Also inform your doctor about recent illnesses
or other medical conditions.
⮚If you are going to be given a sedative during the
procedure, you may be asked not to eat or drink
anything for four to eight hours before your exam.
If so, you may want to have a relative or friend
accompany you and drive you home afterwards
⮚You will receive specific instructions on how to
prepare, including any changes that need to be
made to your regular schedule.
⮚You will likely be instructed not to eat or drink
anything after midnight before your procedure.
Your doctor will tell you which medications you
may take in the morning
⮚Women should always inform their physicians
and x-ray technologist if there is any
possibility that they are pregnant. Many
imaging test are not performed during
pregnancy so as not to expose the fetus to
radiation. If x-ray is necessary, precautions will
be taken to minimize radiation exposure to
the baby.
⮚If you are breastfeeding at the time of the
exam, you should ask your radiologist how to
proceed. It may help to pump breast milk
ahead of time and keep it on hand for use
after contrast material has cleared from your
body, about 24 hours after the test.
 What will you
experience during and
after the procedure?
⮚As the contrast material passes through you body, you may
get a warm feeling
⮚You will be asked to remain very still while the x-ray images
are taken.
⮚The most difficult part of the procedure may be lying flat
for several hours.
⮚You will remain in recovery room for observation for a few
hours following the procedure before you return home.
⮚If the catheter was placed in the groin area, you should try
to keep your leg straight for eight hours. You may apply ice
to the site where the catheter was inserted to relieve pain
and swelling
⮚You may resume normal diet immediately after the exam.
You will be able to resume all other normal activities eight
to 12 hours after the exam
⮚You should report to your physician immediately if
you experience any of the following after your
procedure:

•Weakness or numbness in the muscles of your face,

arms or legs
•Slurred speech
•Vision problems
•Signs of infection at the catheter area
•Dizziness
•Chest pain
•Difficulty breathing
What are the Benefits vs. Risk

Benefits

•Angiography may eliminate the need for

surgery. If the surgery remain necessary, it can
be performed more accurately.
•Cerebral angiography presents a very detailed,
clear and accurate picture of blood vessels in the
brain. This is especially helpful when a surgical
procedure or other treatment is being
considered
• Results from cerebral angiography are more
accurate than others.
• Use of a catheter makes it possible to combine
diagnosis and treatment in a single procedure.
• The degree of detail display by the cerebral
angiography may not be available within any
other procedure.
• No radiation remain in a patient’s body after an
x-ray examination.
• X-rays usually have no side effects in the
diagnostic range.
Equipment:
Catheterization tray consist of : disposable sterile gloves,
drapes, one fenestrated, lubricant, cotton balls with container,
forceps (2), prefilled 10cc syringe with sterile water to inflate
the balloon, sterile specimen container for urine sample
collection.
Sterile catheter, latex (rubber) or silicone: 2 way or 3 way
(where possible, select the non-latex catheter)
Chlorhexidine 2% aqueous solution
Sterile water
Catheter
Secure device or adhesive tape
Urinary bag
Medicated lubricant (Urojet)
Note: select the smallest size catheter that is able
to provide adequate urine drainage. In general:
Size 12-14 Fr for women draining clear urine
Size 14-16 Fr for men draining clear urine
Size 16-18 Fr for patients with debris or mucous in
their urine
Size in excess of 18 FR for patients with hematuria,
unless otherwise specified by physician.
Size 22 Fr for continuous bladder irrigations (CBI’s),
unless otherwise specified by physician
Types and size of catheters

Diameters:
5Fr, 6Fr, 8Fr, 10Fr, 12Fr, 14Fr, 16Fr, 18Fr, 20Fr,
22Fr, 26Fr, 28Fr
The higher the number the larger the diameter
of the catheter.
1Fr. = 0.33mm (i.e. a 24Fr catheter is 8mm in
diameter)
Specific considerations
Pediatric catheterization:
Size 5,6,8,10Fr or smaller depending on the size of the
urethra and age of the child.
Rarely are catheters left indwelling, typically they are
intermittent and are used to obtain sterile urine sample
to rule-out infection.
In children < 2 years if age, a 5Fr feeding tube can be
used if a small diameter catheter is not available.
Using feeding tubes can cause urethral trauna
A second pair of hands for assistance is recommended
for very young children.
Male catheterization:
16Fr or 18Fr catheter is typically used for most
men, as they are more rigid and often easier to
insert past the prostate.
In males it is helpful to use Urojet (syringe with
lidocaine jelly ) to minimize the discomfort with
the catheterization.
Males who present with gross hematuria require
3-way Foley catheter with the largest diameter
that can be safely inserted, (22Fr, 24Fr).
• Catheters should be attached to the inner upper thigh
with a CathSecure. This will minimize discomfort and
prevent the catheter from being pulled on/out.
• When the foreskin is retracted for the purpose of
catheterization remember to return it back to its
original place.
• If resistance is met while inserting the catheter, due
care is used not to damage the enlarged prostate.
• Never inflate the balloon until urine has been
visualized and is draining
Female Catheterization:
12Fr, 14Fr or 16Fr catheter is typically used.
Positioning is important to properly visualize the
urethra in females.
If you are unable to visualize the urethra, raise pelvis
with a pillow, blanket or inverted bedpan.
If you catheter in the vagina leave it in place as a
landmark and start again with another sterile
catheter.
Never inflate the balloon until you see urine.
If patient presents with gross hematuria a larger 3-
way catheter needs to be inserted.
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MORE ABOUT CEREBRAL
ANGIOGRAPHY

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