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A carotid angiogram is an x-ray test that uses an iodine dye and a camera to examine how the blood flows in the main arteries of the neck that lead to the brain. A carotid angiogram can be either an outpatient or an inpatient procedure, typically taking one to three hours to complete.
An angiogram of the neck is done to find blockage of the arteries that carry blood to the brain. A blockage can lead to a stroke or a heart attack. It is also a useful test to determine why symptoms such as severe headaches, slurred speech, loss of memory, numbness, dizziness, poor balance, or double vision is occurring, specifically it will indicate whether a blockage is causing the symptoms. A carotid angiogram can detect if there is an aneurysm, tumor, or hole that is restricting or preventing adequate blood flow to the brain, as well.
Before undergoing an angiogram, it is important to inform the doctor if the patient is pregnant or breastfeeding. In addition, the dye that is used during the test contains iodine; so, any allergy to iodine or shellfish should be reported. In addition, some people with asthma, hay fever, or kidney problems should consider whether an angiogram is right for them.
Usually, a radiologist completes a carotid angiogram. After numbing the area, she will insert a catheter into the artery above the elbow or in the groin. The catheter is the guided to the area that is of concern. Using a camera or fluoroscope, the radiologist will then inspect how the catheter moves in the artery. In addition, an iodine dye is injected through the catheter which makes the area in question show-up in clear contrast in the x-ray photos.
Many people may wonder what it feels like to undergo a carotid angiogram. Initially, a quick pinch will be felt from the local anesthetic. Consequently, most people do not feel any pain when the catheter is paced in the artery. Once the dye is added to the catheter, many people feel a warming sensation for several seconds. When it is time to remove the catheter, a slight pressure may be felt and some tenderness may be experienced at the spot where the catheter was located.
As with any medical procedure, there are a few risks. The main concern with a carotid angiogram is an allergy to the iodine dye. In addition, there is a slight risk of the catheter damaging the artery or dislodging a portion of the clotted blood or other materials from the artery wall. Lastly, there is a risk of damage to cells from the radiation exposure form the x-ray – although this risk in minimal for most people.
Years ago my dad suffered from a stroke—from which he recovered—and this was one of the first procedures the doctors did in the aftermath of the stroke to find out where the blockages were in his body. They tracked the iodine as it traveled through his arteries. I later found out that there were many kinds of tests they could use, but that this was considered the “gold standard” in detecting problems.
Fast forward twenty years later, and I started feeling chest pains. I ignored them at first but they got worse, so I checked into the emergency room. They performed the whole battery of tests, treadmill, blood tests, ultrasound, etc. and said that I was perfectly normal. They
didn’t perform any carotid angiograms but I was told this was only necessary in certain situations. I had always wondered why they didn’t perform it but in the end I left everything to the doctor’s judgment. I guess he made the call that I had nothing but heartburn. Nowadays they also have some ultrasound tests that they perform around your neck but I don’t know how reliable those are.
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