What is an angiogram?
An angiogram is a minimally invasive test that uses a special contrast solution (dye) and imaging technology to map the arterior veins in a part of your child's body. A cerebral angiogram maps the blood vessels in the brain. It is performed by a specially trained doctor called an interventional radiologist or a neurointerventional radiologist.
Darren B. Orbach, MD, PhD, Neurointerventional Radiologist at Boston Children's Hospital, explains the process of a cerebral angiogram and the role of image guidance and catheters.
How should I prepare my child for the angiogram?
Explain to your child in simple terms why the test is needed and what will happen. You can say that you will be close by and that she may bring a favorite toy or blanket into the procedure room.
Some children need to come to the Perioperative Care Coordination Clinic for lab tests and exams by a nurse, anesthesiologist, and nurse practitioner. Please allow two to four hours for the preoperative visit.
What will happen before the angiogram?
A staff person from the hospital will call you a few days before the procedure with preparation instructions that will include dietary restrictions necessary for sedation or anesthesia. It is very important that you follow all of these instructions, or the procedure may need to be rescheduled. When you arrive at the hospital:
- The interventional radiologist or neuroradiologist will talk to you about the procedure and ask you to sign the consent form. (You must be your child's legal guardian to sign this form. If you are a legal guardian and not a parent, you must bring the paperwork showing proof of legal guardianship.)
- Your child will change into a hospital gown.
- A nurse or anesthesiologist may start an intravenous (IV) line.
- Once your child is asleep, you will be escorted to a special waiting area.
What happens during the angiogram?
The radiology technologist will clean your child's groin with a special liquid that helps prevent infection.
Through a tiny incision, the interventional radiologist will insert a small needle into the appropriate blood vessel, usually at the crease of the hip. This will provide access for insertion of a long, thin tube (the catheter) into the vessel.
Under x-ray guidance, the radiologist will guide the catheter to the blood vessel being studied, and then will inject a special contrast solution through the catheter so that she can see your child's blood vessels more clearly.
Several x-rays may be taken. If awake, your child needs to hold her breath and keep very still during this part of the procedure.
When the angiogram is finished, the radiologist removes the catheters and applies a bandage.
Your child is transferred to the recovery room, where you may join her. A nurse will watch your child closely for four to six hours, and your child will need to lie still without bending the leg during that time.
The radiologist will speak with you after the procedure and explain the findings and results.
Are angiograms safe?
Angiograms are considered minor surgical procedures. Angiograms are generally safe, but as with any surgical procedure, carry some risk of complication. The doctor will explain potential side effects and complications before you are asked to consent to the procedure.
During angiography, your child will be exposed to ionizing radiation (x-rays). While we strive to minimize exposure to x-rays, we believe that the benefit to your child's health outweighs the exposure that occurs during the angiogram. Because children are more sensitive to radiation exposure than adults, we have been leaders in adjusting equipment and procedures to deliver the lowest possible dose to young patients.
How Boston Children’s Hospital approaches angiograms
Angiography and cerebral angiography in children is different than in adults, because children have smaller and more delicate blood vessels. Our physicians are highly trained in using the specialized techniques and small catheters necessary for performing angiograms in children.
In addition to the radiologist, your child will be cared for by a team of anesthesiologists, nurse practitioners, nurses, and technologists who specialize in caring for children undergoing interventional radiology procedures and treatments.
We perform angiograms in a suite, which features three procedure rooms equipped with the latest imaging technology, a recovery area for patients who have received sedation or anesthesia, and examining rooms for outpatient visits.