A carotid angiogram is a test to look at the large blood vessels in your neck that carry blood to your brain. These are called the carotid arteries. A catheter is inserted into your groin, or possibly your arm. The catheter is advanced to visualize the aortic arch, carotid arteries, and smaller arteries of the brain. Using contrast, the image will be seen on the video screen. The doctor can see if there is any blockage or narrowing of the artery.

WHY MIGHT I NEED A CAROTID ANGIOGRAM? You may need a carotid angiogram to help your healthcare provider find problems in the blood vessels supplying your head and neck. These problems may include: • Bulging of a blood vessel (aneurysm) • Narrowing of a blood vessel (stenosis) • Spasm of a blood vessel (vasospasm) • An abnormal connection between arteries and veins (arteriovenous malformation) • Blood clot (thrombosis) • Blockage (occlusion) You may need a carotid angiogram if another test such as a CT scan or MRI did not give your provider enough information. There may be other reasons specific to your health indicating that this testing would be recommended by your physician.



• Bleeding, swelling caused by a collection of blood (hematoma), injury to nerves, or infection.


• Damage to an artery or an artery wall. This can cause blood clots, abnormal ballooning of the artery, or abnormal link between the artery and nearby vein.


• Temporary kidney failure. Please notify your provider if you have had recent imaging testing that included contrast, as this would increase your risk for kidney issues.




• Are pregnant or think you may be pregnant. Radiation exposure during pregnancy may lead to birth defects.


• Are allergic to or sensitive to any medications, contrast, latex, tape, or anesthetic medicines (local or general).


• Have kidney failure or other kidney problems. In some cases, the contrast can cause kidney failure. You are at higher risk for this if you take certain diabetes medicines. You may need to hold certain medications prior to the procedure.


• Are taking any medication that include prescriptions, over-the-counter, and herbal supplements.


Have a bleeding disorder or take blood thinners, aspirin or medications or supplements that affect blood clotting. These may have to be stopped prior to the procedure.





• You will need to have blood work prior to your procedure. You should receive an order from your physician.


• You will be asked not to eat after midnight prior to the procedure. You may have clear liquids 2 hours before your arrival time.


• Bring your insurance card and picture ID with you to the appointment. You may bring an adult guest with you.


• You will need a driver to your appointment. If you need transportation, please let the office know so that we can arrange it for you.



• You will read and sign your consent that gives your permission for the procedure to be performed. You will have the opportunity to ask your provider questions and have anything explained that you do not understand.


• You will be asked to remove any clothing or jewelry that may get in the way of the test. You will be given a gown to wear. You will be asked to empty your bladder prior to the test.


• An intravenous (IV) line will be started in your hand or arm. You will be connected to a monitor that records your heart rate, blood pressure, and breathing.


• You may get medication to help you relax before the procedure.

WHAT HAPPENS DURING A CAROTID ANGIOGRAM? • The skin in your groin will be shaved and cleansed. Your ankle and foot or arm may be cleansed and prepared in certain cases. The skin will be injected with a local pain medication to numb the area. A needle will be inserted into the artery. A catheter will be placed in the artery and advanced for imaging. Fluoroscopy is used to see the catheter. When contrast is injected, you may feel a warm, flushing sensation, salty or metallic taste, a brief headache, or nausea. These effects usually last for a few moments. • A Certified Sedation nurse monitors you 1-on-1 during your procedure. You will receive anesthesia that allows for conscious sedation. The medication will make you feel very relaxed and alleviate any pain. You may drift to sleep. You will not be intubated and can breathe comfortably and unassisted. Supplemental oxygen is used during anesthesia. • Tell the physician or nurse if you experience any trouble breathing, sweating, numbness, or heart palpitations. • If it is determined that an intervention is needed and can be done at that time, (atherectomy, percutaneous balloon, or stenting) it can be done during the procedure. These procedures are included in the consent form as treatment possibilities. • Once the procedure is completed, the physician will remove the catheter. Pressure will be applied to the site to keep it from bleeding. A closure device or continued manual pressure may be used to close the puncture site. After the bleeding stops, a dressing will be applied on the site. WHAT HAPPENS AFTER A CAROTID ANGIOGRAM? • You will be taken to the recovery room. A nurse will watch your vital signs and the access site(s). They will check the circulation and sensation in your extremities. • Depending on the closure device used, you will be discharged after a period of rest and no signs of bleeding. • You will be encouraged to drink water and fluids to help flush the contrast from your body. • You will receive written discharge instructions about returning to your daily activities and how to care for your bandage and incision site. AT HOME • Once home, you should watch the injection site for bleeding. A small bruise is normal. So is an occasional drop of blood at the site. • You should watch your arm or leg for changes in temperature, color, pain, numbness, tingling, or loss of movement. • Drink plenty of fluids to help the contrast leave your body. You may not be able to do any strenuous activities or take a bath or shower for a period of time after the procedure.