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01.05 Cerebral Angiography

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Overview

  1. Cerebral angiography
    1. Contrast into arteries
    2. X-ray
    3. View blood flow in brain

Nursing Points

General

  1. Radiologist inserts catheter in artery (usually leg)
    1. Guided by X-ray
    2. Placed in vessels supplying brain
  2. Iodine contrast injected through the catheter
  3. X-ray to view blood flow in brain (radiation)
  4. Purpose -> diagnose brain disease or aneurysms

Assessment

  1. Before
    1. Doctor may hold anticoagulants
    2. NPO 6-8 hours prior
    3. Ask patient if allergic to contrast
    4. Consent signed

Therapeutic Management

  1. During
    1. Clean and shave
    2. Sedative through IV (nurse or radiology tech)
    3. Sometimes general anesthesia
    4. Doctor places and threads catheter through leg artery
    5. Monitor vital signs
  2. After
    1. Radiologist removes catheter
    2. Apply pressure 10-15 minutes (closing device if needed)
    3. Keep patient flat for 2 hours to avoid bleeding
    4. Keep leg straight up to 6 hours
    5. Assess for bleeding

Nursing Concepts

  1. Intracranial regulaton -> view and diagnose deviations from normal
  2. Safety -> radiation
  3. Patient education -> when to restart meds after

Patient Education

  1. Doctor order when to restart anticoagulants
  2. Okay to resume activity next day
  3. Call doctor if any redness or pain at injection site in leg

Reference Links

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Video Transcript

Hey guys! Welcome to the lesson about the cerebral angiography.

A cerebral angiography is a procedure where the radiologist or doctor inserts a catheter into an artery, usually the leg, and they thread that catheter up to the vessels supplying the brain. They do this with a guiding X-ray. Iodine contrast is then injected into the catheter and the X-ray will show the blood flow in the brain using radiation to bounce off of the tissues. The purpose of this procedure is to view and diagnose brain disease or aneurysms. This picture shows a picture from this test showing an aneurysm in the brain vessel here. Let’s explore what to do before the procedure. 

If the patient is on anticoagulants, ask the doctor if they want them held before the test, and for how long. The patient will be NPO meaning no food or drink for 6 to 8 hours before the procedure. Ask the patient if they have any allergies to contrast dye. Explain the procedure and have the patient sign the consent. this consent may be done at the bedside before the procedure so that the doctor may explain any risks. 

During the procedure, the nurse will clean and shave the upper leg and groin area. The patient will receive a sedative through the IV by the nurse or radiology tech. It’s sometimes necessary to use general anesthesia on the patient, like if they have a hard time getting them to relax for the procedure. Thee doctor will place and thread the catheter through the leg artery and up to the vessels supplying the brain where they will inject the contrast and use the X-ray. You will monitor the patient’s vital signs during the procedure for any variations. 

After the procedure, the doctor will remove the catheter. You will apply pressure for 10 to 15 minutes after. A closing device may be used. Keep the patient flat for 2 hours to avoid bleeding. The patient will need to keep their leg straight for up to 6 hours to prevent bleeding as well. You will monitor this patient’s vital signs and assess for bleeding at the insertion site. Next we will talk about patient education. 

Let the patient know when they will be able to start their anticoagulants based on what the doctor ordered. The patient can continue their normal activities the next day. Tell them to let the nurse know or call the doctor if they are at home and experience any redness or pain at the injection site. 

The priority nursing concepts for the patient with a cerebral angiography are intracranial regulation, safety, and patient education. 

Alright, let’s review the key points. A cerebral angiography is a procedure where a catheter is inserted into the leg artery up to the brain vessels and contrast is injected and the cranial vessels are viewed with an X-ray for any disease or aneurysms. Before the procedure, you will get consent and stop any anticoagulants with a doctor’s order. The patient will be NPO before the procedure. After it’s over, you will hold pressure for 10 minutes and may use a closing device. Monitor the vital signs and assess the site for bleeding. Keep the patient flat for 2 hours, and the leg straight for 6 hours to prevent bleeding. Let the patient know they may continue normal activity the next day, and to keep an eye on that injection site for any redness or pain. 

Okay guys, that’s it on cerebral angiography! No go out and be your best self today, and as always, happy nursing!

 



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