Interventional neuroangiography involves image-guided procedures to diagnose and/or treat pathologies such as cerebral aneurysms, arterio-venous malformations and fistulae. Historically such procedures required invasive surgery but can now often be treated by endovascular techniques offering reduced physical trauma, less pain and recovery time thus reducing hospital stay. An interventional neuroradiologist, along with a multidisciplinary team of radiographers and nurses, will conduct your examination in our theatre/angio suite.
There is a wide range of procedures undertaken in the angio suite at NHNN. Patients are referred for this service by their consultant neurologist/neurosurgeon, after discussions have taken place with a multidisciplinary team about treatment and/or diagnostic options.
Following the MDT decision you will be given instructions prior to hospital admission and may be asked to attend a pre-assessment clinic. You will be asked to attend the hospital on the morning of, or the night before, your procedure.
Please contact Neuroradiology before your procedure if any of the following apply:
- There is any possibility of pregnancy
- You require an interpreter
- You have diabetes mellitus, or take metformin
- You have a history of thyroid problems
- You are expecting to undergo radioisotope scanning of your thyroid
- You have a history of renal problems
- You have a known allergy/previous reaction to iodine-based contrast.
If your procedure is under general anaesthetic please refer to any eating and drinking guidance you receive at your pre assessment appointment with the anaesthetist. If your procedure is under general anaesthetic you may also be required to stay overnight so you may want to bring an overnight bag with you.
If your procedure is under local anaesthetic please refer to your appointment letter or patient information leaflet. If you are unsure how your procedure will take place and what guidance you should follow, please contact the admissions or Neuroradiology departments directly.
The interventional neuroradiologist will discuss all related risks and benefits of your specific procedure with you in clinic before admission or when you are admitted to the hospital ward before attending the angio suite. They will give you time to discuss with your relatives and carers and make a decision to proceed before asking you to sign a consent form.
You will be asked to change into a hospital gown and compressive stockings. The nurse looking after you will escort you to and from the angio suite. Depending on the procedure you are having you will need to stay in the hospital between four hours and a few days afterwards.
The length of the procedure will vary depending on the area of the body and pathology to be examined or treated; this can take between 30 minutes and three hours. It may take longer if you are having the procedure under general anaesthetic. You will be asked to lie on a couch and keep as still as possible. You may also be asked to follow breathing instructions, whilst we acquire x-rays during your procedure.
During an angiogram it is necessary to give you an injection of iodine-based contrast (a type of dye that highlights blood vessels and other structures in the body) to provide more detail and information to your referring clinician. This contrast injection will be administered by the interventional neuroradiologist through a sheath (small plastic tube), usually placed in the artery at the top of your leg or in your arm. You may experience a warm feeling all over your body during the contrast injection but this will pass very quickly. If you are asleep for the procedure you will not feel anything whilst under general anaesthetic.
The procedures and examinations performed in the angio suite at NHNN are not limited to angiograms, we perform a wide array of procedures: embolisation treatments, x-ray guided lumbar punctures, sclerotheraphy, cerebral venograms, cisternograms and myleography and spinal procedures such as vertebroplasties. Please see specific procedural patient information leaflets for further guidance or speak with your referring clinician.
The use of x-rays presents a very small risk. Our imaging equipment and modern techniques ensure the radiation dose is as low as possible. In addition, your referring clinician and the performing Interventional Neuroradiologist will have made a judgement about your risk and benefit.
Patients of child bearing capacity between the ages of 12 and 55 years are required by law to be asked about possible pregnancy when undergoing examinations involving x-ray. Patients who either are, or think they may be, pregnant must inform the Neuroradiology department as soon as possible. In some urgent cases the x-ray may still go ahead but with additional precautions in place.