Cerebral angiography is a new X-ray technique that has been widely used in clinical practice since the 1990s. It involves selecting an access artery, usually the right femoral artery, placing an arterial sheath through the right femoral artery, selecting a different catheter through the arterial sheath, selecting the artery to be shown under the guidance of a guide wire, and injecting iodine-containing contrast. The trajectory of the vessel through which the contrast agent passes is continuously photographed and imaged by electronic computer-aided imaging as digital subtraction angiography (DSA) of the cerebral vessels.
Because DSA can not only clearly display the vascular images of the internal carotid artery, vertebrobasilar artery, large intracranial vessels and cerebral hemispheres, but also measure the blood flow of arteries, it has been used for cerebrovascular disease examination, especially for the qualitative localization and diagnosis of aneurysms and arteriovenous malformations. It can not only provide the exact location of the lesion, but also a clear understanding of the extent and severity of the lesion, providing a more reliable objective basis for surgery. In addition, DSA is also of high diagnostic value for ischemic cerebrovascular disease, as it can clearly show arterial lumen stenosis, occlusion, and the establishment of collateral circulation, etc. For cerebral hemorrhage and subarachnoid hemorrhage, it can further identify the causes of hemorrhage, such as aneurysm, vascular malformation, cavernous hemangioma, etc. In conclusion, DSA is a proven diagnostic method for the diagnosis of cerebrovascular disease.
Indications.
1, intracranial vascular diseases, such as atherosclerosis, embolism, stenosis, occlusive disease, arteriopathy, arteriovenous malformation, arteriovenous fistula, etc.
2, intracranial occupying lesions, such as intracranial tumors, abscesses, cysts, hematomas, etc.
3, various extracerebral hematomas due to craniocerebral trauma.
4, observation of cerebrovascular circulation status after surgery.
Cerebral angiography is one of the most effective methods to examine cerebrovascular disease. It is performed by injecting an iodine-containing contrast agent into the internal carotid artery or vertebral artery to visualize the cerebral vessels to understand the morphology and lesions of the cerebral vessels themselves, as well as the nature and extent of the lesions. This test is of particular value in the diagnosis of cerebrovascular disease.
So, which vascular diseases need cerebral angiography?
1.Patients with cerebral hemorrhage who have indications for surgical resuscitation, but the location of the hematoma is not clear, need to make cerebral angiography.
2, cerebral hemorrhage suspected to have epidural or subdural hematoma
3, subarachnoid hemorrhage is mostly caused by intracranial aneurysm or vascular malformation. Cerebral angiography is necessary to make a clear diagnosis for surgical treatment.
4. If a patient with cerebral tumor has a stroke attack and cannot be distinguished from cerebral hemorrhage or cerebral infarction, cerebral angiography can also be considered to help the differential diagnosis.
5.If there is a lesion in the external carotid segment of the internal carotid artery, angiography should be performed if there is a surgical condition.
How to perform cerebral angiography?
First of all, before receiving the angiogram, the patient must make a drug (iodine) sensitivity test. If there is no adverse reaction, the patient can receive the imaging. However, the patient must be fasted from food and water before the imaging to avoid nausea and vomiting. The patient’s neck should then be washed with soapy water. After local anesthesia, a puncture needle is inserted into the carotid artery on the side of the lesion, and a rapid (1 second) injection of the drug is made. Simultaneous x-rays are performed to visualize the cerebral vessels.
Cerebral angiography is relatively safe, but in a few patients a hematoma can form at the neck puncture site, which usually fades away after a few days.
What is cerebral angiography and what are its indications and contraindications?
Angiography is an X-ray projection technique in which a contrast agent is injected directly into the blood vessels to visualize the cerebrovascular system. The angiogram can specifically understand the morphological changes of the blood vessels, such as travel, distribution, displacement, thickness and changes in circulation time. Ultimately, it is determined whether the lesion is a blood vessel itself or a lesion in other parts of the skull causing vascular changes, which provides a basis for clinical diagnosis and treatment.
Indications.
1, intracranial vascular diseases, such as intracranial aneurysm, arteriovenous malformation, arteriovenous fistula, arterial embolism, etc.
2, intracranial occupying lesions, such as intracranial tumors, abscesses, cysts, hematomas, etc.
3, extracerebral hematoma caused by traumatic brain injury.
4, post-operative observation of surgical effect and cerebral blood circulation status.
Contraindications.
1.Caution is needed for those with age-related arteriosclerosis.
2.Persons with severe cardiac, renal and hepatic insufficiency.
3.Those with allergy to contrast agent.
4.People with serious bleeding tendency.