Spinal Angiogram

What is a spinal angiogram? 

A spinal angiogram is a specialized diagnostic X-ray that shows detailed images of the blood vessels surrounding the spinal cord. This minimally invasive procedure is normally used to look for abnormalities in these blood vessels or to treat vascular problems. It allows for a more detailed look into the blood vessels compared to an MRI (magnetic resonance imaging) or CT (computerized tomography) scan. 

The spinal angiogram is usually done under light sedation. During the procedure, a catheter (a long and thin plastic tube) is placed in an artery in the leg and guided to the blood vessels of the spine. Through the catheter, a contrast dye is injected into the bloodstream so that the blood vessels will be visible during the X-ray. Snapshots or films will be taken from different angles for doctors to analyse. 

What can you expect?

The area where the catheter will be inserted is usually numbed to ensure that the rest of the procedure is as painless as possible. While you may not feel the catheter moving or being inserted, you may feel sensations of warmth when the contrast dye is injected through the catheter. After the X-rays are over, the catheter will be removed. The incision site would be closed by manual compression or by a special closure device. 

After the whole procedure is over, you will have to lie flat for about two to six hours. Around the area where the catheter was inserted, it is common to experience bruising and soreness. This will diminish as the wound heals. You should not drive 24 hours after the surgery so it is a good idea to arrange transportation back home from where the surgery took place. Additionally, it is important to rest and abstain from any physical activity for 48 hours after the surgery. Doctors may want to discuss the results with you after surgery or may want to review the results first. 

When would you need a spinal angiogram?

A doctor would recommend carrying out a spinal angiogram if you are suspected of having problems in the veins or arteries of your spinal cord. Some of these common spinal conditions include Spinal Dural Arteriovenous Fistula, Spinal Pial Fistula, Spinal Epidural Fistula or Spinal AVM. 

Spinal angiograms help to diagnose problems in the arteries and veins of the spinal cord. They help by showing the narrowing or blockage of blood vessels, abnormally dilated vessels and bleeding sites. Other times, there might be an unexplained problem that requires further investigation and information that simply cannot be obtained from an MRI or CT scan. 

What are some risks or side effects?

While spinal angiograms are safe and effective, as with any medical procedure there are possible risks to be aware of before going through the procedure. However, your doctor would have ensured that you are medically fit to undergo this procedure beforehand. Your doctor would have requested this procedure be carried out as there is no other alternative to obtain the information needed. 

Fortunately the risk of getting a spinal cord stroke has been tremendously reduced from the past, and neurological complications arising from spinal angiograms are extremely rare. Advances have also been made to contrast dye and toxicity and allergic complications have been reduced. However, there is still a chance of a life-threatening allergic reaction. It is important to inform your doctor if you have had a previous contrast allergy or if you are allergic to iodine/shellfish. These types of allergies can be treated with steroids and antihistamines.