Diagnostic Cerebral Catheter Angiography

Overview

The most common indications for a DSA are:

• investigating a suspected cerebral or spinal vascular disease (e.g., aneurysms, vascular malformations, fistulas, tumors, etc.)
• preoperative planning
• postoperative check to evaluate the surgical result

DSA is often not the first step when investigating vascular diseases, but it is nonetheless an essential one. Often, the method is indispensable for reliably detecting or excluding a diagnosis.

At the USZ, we perform angiography mostly on an outpatient basis and under local anesthesia.

Advantages and disadvantages

Advantages

• Angiography is usually essential for the diagnosis of neurovascular diseases and for surgical planning and control.
• DSA produces high-resolution images and provides information that cannot currently be obtained with non-invasive methods.

Disadvantages

• DSA is an invasive method and is therefore associated with certain risks. However, modern technology can minimize those.

Course of treatment

We usually perform angiography on an outpatient basis. As a patient, you must fast for at least four hours before the examination. This means that you are not allowed to eat any solid food and you can drink only small amounts of clear liquids. However, you can continue taking any medication which you require for unrelated health problems unless there is a special risk associated with them.

The procedure is minimally invasive and and IS performed under local anesthesia. First we puncture the femoral artery (thigh artery) in the groin region. Then we image the blood vessels by inserting a tiny catheter and injecting contrast medium. The latter may cause a warm or hot sensation. After the angiography is completed, we manually compress the groin for a few minutes and finally apply a pressure bandage.

Aftercare

After the examination, you are required to rest in bed for six hours and to wear a compression bandage. Usually, patients can then go home still on the same day. It is possible to work in the days following the procedure, but heavy lifting and heavy physical labor should be avoided for a few days.