Carotid Angiography

What is carotid angiography?

Carotid angiography, or angiogram, is a test to help diagnose carotid artery disease. Providers do this test to see how blood moves through the large arteries in your neck. Carotid angiography uses X-rays to take images and a special dye to make your arteries visible.

When is carotid angiography performed?

The carotid arteries are two large blood vessels on either side of your neck. These arteries move blood from your heart to your brain and head. In carotid artery disease, these arteries become narrowed or blocked due to atherosclerosis.

Your healthcare provider may recommend carotid angiography when they suspect you have carotid artery disease. You may also have this test if you’ve had a mini-stroke (transient ischemic attack) or stroke.

What tests might I have before carotid angiography?

If you have carotid artery disease symptoms, healthcare providers may recommend a noninvasive test called a carotid ultrasound. If carotid ultrasound images aren’t clear or your provider wants to see more detail, they may recommend carotid angiography.

Who performs carotid angiography?

A provider specializing in image-guided procedures (interventional radiologist) performs carotid angiography.

How does carotid angiography work?

To perform carotid angiography, your provider:

1. Inserts a thin, flexible tube (catheter) into a blood vessel, usually near your groin but sometimes in your arm.
2. Injects a special liquid (contrast dye) that makes your arteries visible under X-ray.
3. Takes X-ray images.

Your provider may do CT carotid angiography using a CT scan (computed tomography scan) or magnetic resonance angiogram (MRA) using MRI (magnetic resonance imaging) instead of X-ray.

How do I prepare for carotid angiography?

Before carotid angiography:

• Fast: Follow your healthcare provider’s instructions regarding eating and drinking before the procedure.
• Medications: Tell your provider about any medications (including aspirin) or herbal supplements you take. Follow your provider’s instructions about whether you should take them before the procedure.
• Valuables: Leave any jewelry or other valuables at home.
• For an overnight stay: Bring comfort items you might need (such as a robe or slippers).
• For an outpatient procedure: Make sure you have someone to drive you to and from the test.

What should I expect when I arrive for carotid angiography?

You'll change into a hospital gown for the procedure. If you wear glasses or hearing aids, ask your healthcare provider if you can wear them during the test. Don’t wear contact lenses during the procedure.

What should I expect during carotid angiography?

Carotid angiography takes 60 to 90 minutes. Your provider will:

1. Place a catheter in a vein in your arm to deliver medications and fluids intravenously (IV).
2. Give you medication to help you relax (sedative).
3. Apply sticky patches (electrodes) to your chest to check your heart’s electrical activity with an electrocardiogram (EKG) during the procedure.
4. Numb your groin (or arm) with local anesthesia.
5. Place the catheter and inject contrast dye into the catheter to make your arteries more visible.

Is carotid angiography painful?

Typically, carotid angiography isn't painful. Some people feel a flush of heat when providers inject the contrast dye. This feeling may last for just a few seconds. Tell your healthcare provider if you have:

• Chest pain or discomfort.
• Itchy skin.
• Nausea.
• Symptoms of anaphylaxis (such as tightness in your throat).
• Trouble with your vision.

What should I expect after carotid angiography?

When the test ends, your provider will:

1. Remove the catheters.
2. Cover the area with a bandage to stop any bleeding.
3. Check your heart rate and blood pressure.
4. Move you to a room where you can rest for several hours.

You should drink fluids to help you flush the contrast dye from your body, and you may need to urinate more often. Follow your healthcare provider’s instructions about getting up and moving around.

What do carotid angiography results show?

Carotid angiography shows any blockages or narrowing of your carotid arteries. An obstruction in your carotid artery can increase your risk of stroke. Healthcare providers use the results of carotid angiography to determine this risk and decide if you need treatments.

When will I know the results of carotid angiography?

A radiologist, an expert specializing in interpreting images, examines the images taken during the procedure. The radiologist sends a report to your provider. Your provider contacts you to discuss the results and next steps.

When should I call my healthcare provider after carotid angiography?

Call your healthcare provider if you experience any signs of an allergic reaction or don’t feel well.

How do healthcare providers treat carotid artery disease?

If your carotid arteries are narrow or blocked, healthcare providers may treat you with:

• Carotid endarterectomy.
• Carotid stenting.
• Medications to reduce your risk of blood clots.

A note from Cleveland Clinic

Healthcare providers use carotid angiography, or angiogram, to look for blockages and narrowing in your carotid arteries, the blood vessels that carry blood from your heart to your brain. If your carotid arteries are narrow or blocked, you may be at higher risk for stroke.