Have you ever suddenly felt dizzy, had a feeling of numbness on one side of your body, or had difficulty speaking? Sometimes these can be signs of a mini-stroke. When this happens, the main thing doctors will look for is whether there is a blockage in the main artery in your neck that carries blood to your brain. That's what we're going to talk about today.
What is Carotid Angiography?
Simply put, a carotid angiogram, or angiogram, is a special test that looks at how blood is flowing in the two main blood vessels on either side of your neck (what we call the carotid arteries). Think of these two arteries as the two main arteries that carry blood from your heart to your brain. This test is done to see if there is a blockage or narrowing in any of these arteries.
This involves taking pictures using X-rays. But even with a simple X-ray, these blood vessels are not clearly visible. Therefore, a special liquid, a type of dye called ``contrast dye'', is injected into the body. This dye makes the blood vessels appear white on the X-ray. Just like when you drive on a dark road with your headlights on, you can see the road clearly.
Why do you need to do this test?
The main reason for doing this test is if there is a suspicion of Carotid Artery Disease . What happens in this is that over time, things like cholesterol build up inside these blood vessels, thickening the vessel walls and narrowing the blood flow. Just like over time, rust builds up inside a water pipe in our house and clogs the water flow. In medicine, we call this `(Atherosclerosis)`.
There are several main reasons why your doctor may refer you for this test:
- If your doctor suspects that you have symptoms of carotid artery disease.
- If you have previously had a mini-stroke , or what is medically known as a ``Transient Ischemic Attack - TIA''.
- If you have previously had a major stroke .
The most important thing is that blockage of these arteries can reduce the amount of blood that reaches the brain. This greatly increases the risk of stroke. Therefore, it is very important to get this test done and identify the condition early.
Will you do any other tests before this one?
Yes. Usually, a doctor does not immediately refer you for this angiography test. Before that, they often do a carotid ultrasound test. This is a very simple, painless, scanning test that uses sound waves. However, sometimes if the images from this ultrasound test are not very clear, or if the doctor wants to know more about the condition of the artery, the next step is to refer you for a carotid angiography test.
How to prepare for the test?
Your doctor or hospital staff will give you clear instructions on how to prepare for this test. It is very important to follow those instructions exactly.
| The section to be prepared | What to do and description |
|---|---|
| Food and drink | You will be told not to eat or drink anything for a few hours before the test. This means you must fast. Follow that advice exactly. |
| The medications you take | Be sure to tell your doctor about any medications you take daily (e.g. aspirin, diabetes medication, blood pressure medication) and any Ayurvedic medicines you are taking. You may be asked to stop taking some medications the day before the test. |
| Valuable things | Leave your valuables, such as jewelry and money, at home. Avoid bringing these to the hospital. |
| Getting to and from the hospital | You may not be able to drive after the test, so it is essential that you have someone to drive you home. |
What happens during the test?
The entire process usually takes about an hour or an hour and a half. There is no need to worry, everything is done with your safety in mind.
After arriving at the hospital
You will be given a hospital gown to wear. If you wear glasses or hearing aids, ask the doctor or nurse if you can wear them during the test. However, contact lenses must be removed.
Testing process
The table below will help you understand this process better.
| Steps | What is happening? |
|---|---|
| Placing the IV line | A small tube (IV catheter) will be inserted into a vein in your arm. The necessary medications and fluids will be given through this. |
| Giving sedatives | You will be given a mild sedative to relax you and reduce your anxiety. This may also help you fall asleep. |
| Heart rate monitoring | Electrodes are attached to your chest and connected to an EKG machine. This monitors your heart's activity throughout the test. |
| Giving medicine for numbness | A local anesthetic is injected into the area where the catheter is inserted, usually the groin area or sometimes the arm. |
| Catheter insertion and die drilling | After the anesthesia, a very thin, flexible tube (catheter) is inserted into the blood vessel and guided to the carotid artery in the neck. Then, dye is injected through the tube. X-ray images are then taken. |
Is this painful?
No. This is not usually a painful test. You will not feel any pain because the catheter will be numbed. However, you may feel a slight warmth or tingling sensation as the dye is injected into your body. This is normal. The warmth will go away in a few seconds.
However, if you experience any of the following symptoms during the test, you should tell the doctor or nurse immediately:
- Chest pain or discomfort
- A skin rash or itching
- Feeling nauseous.
- Feeling like your throat is constricted
- Any change or blurring in vision
What happens after the test?
When the test is finished, the doctor will remove the catheter and apply a bandage to stop the bleeding. Then, your heart rate and blood pressure will be checked, and you will be moved to a separate room to rest for a few hours.
You will be advised to drink plenty of water during this time. This is because the dye injected into your body needs to be quickly flushed out through your urine. So don't worry if you need to urinate a little more, it's normal.
What do the results say and when will they be available?
The X-ray images taken from this test can clearly show if there is any blockage or narrowing in your carotid arteries.
These images are examined by a specialist, a radiologist, and a report is prepared. This report is sent to your treating doctor. The doctor will then talk to you and explain the results and, if necessary, the next steps to take.
Take-Home Message
- Carotid angiography is a special X-ray test that checks for blockages in the main arteries in your neck that supply blood to your brain.
- This test is very important for early detection of narrowing or blockages in the arteries that can lead to stroke.
- This procedure is usually not painful, but it is essential to follow the doctor's instructions carefully before and after the test.
- If you experience any unusual symptoms (e.g., an allergic reaction, severe pain at the catheter insertion site) after the test, notify your doctor immediately.
- Always talk openly with your doctor about your test results and future treatments.
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