Carotid Angiogram: Before Your Procedure

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What is a carotid angiogram?

Carotid artery

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 carotid arteries. The doctor puts a thin, flexible tube (catheter) into a blood vessel in your groin. Or the doctor may put the catheter in a blood vessel in your arm or shoulder. You may have this test to see if a carotid artery is blocked.

During the procedure, the doctor moves the catheter through the blood vessel into your neck. Then he or she injects a dye into the catheter. The dye flows into the blood vessel. A picture of your carotid artery shows up on a video screen. The doctor can look at the screen to see any blockage or narrowing of the artery.

If your carotid artery is blocked, the doctor may do an angioplasty. The doctor uses a catheter with a tiny balloon at the tip. He or she puts it into the blocked area and inflates it. The balloon presses the fatty buildup (plaque) against the walls of the artery. This makes more room for blood to flow. In most cases, the doctor then puts a stent in the artery. A stent is a small, expandable tube that presses against the walls of the artery. The stent is left in the artery. It keeps it open and helps blood flow. The stent also may keep small pieces of plaque from breaking off and causing a stroke.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

What happens before the procedure?

Procedures can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for your procedure.

Preparing for the procedure

  • Understand exactly what procedure is planned, along with the risks, benefits, and other options.
  • Tell your doctors ALL the medicines and natural health products you take. Some of these can increase the risk of bleeding or interact with anesthesia.
  • If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if you should stop taking these medicines before your procedure. Make sure that you understand exactly what your doctor wants you to do.
  • Your doctor will tell you which medicines to take or stop before your procedure. You may need to stop taking certain medicines a week or more before the procedure. So talk to your doctor as soon as you can.
  • If you have an advance care plan, let your doctor know. Bring a copy to the hospital. If you don't have one, you may want to prepare one. It lets your doctor and loved ones know your health care wishes. Doctors advise that everyone prepare these papers before any type of surgery or procedure.

What happens on the day of the procedure?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your procedure may be cancelled. If your doctor told you to take your medicines on the day of the procedure, take them with only a sip of water.
  • Take a bath or shower before you come in for your procedure. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Take off all jewellery and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery centre

  • Bring a picture ID.
  • You will be kept comfortable and safe by your anesthesia provider. You may get medicine that relaxes you or puts you in a light sleep. The area being worked on will be numb.
  • The procedure will take about 90 minutes.
  • After the procedure, pressure will be applied to the area where the catheter was put in your blood vessel. Then the area may be covered with a bandage or a compression device. This will prevent bleeding.
  • Nurses will check your heart rate and blood pressure. The nurse will also check the catheter site for bleeding.
  • If the catheter was put in your groin, you will need to lie still and keep your leg straight for several hours. The nurse may put a weighted bag on your leg to keep it still.
  • If the catheter was put in your arm, you may be able to sit up and get out of bed right away. But you will need to keep your arm still for at least 1 hour.
  • You may have a bruise or a small lump where the catheter was put in your blood vessel. This is normal and will go away.

Going home

  • Be sure you have someone to drive you home. Anesthesia and pain medicine make it unsafe for you to drive.
  • You will be given more specific instructions about recovering from your procedure. They will cover things like diet, wound care, follow-up care, driving, and getting back to your normal routine.

When should you call your doctor?

  • You have questions or concerns.
  • You don't understand how to prepare for your procedure.
  • You become ill before the procedure (such as fever, flu, or a cold).
  • You need to reschedule or have changed your mind about having the procedure.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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