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Spinal Angiogram

Introduction

hSpinal angiograms are the pictures obtained when performing spinal angiography. Pictures obtained with conventional spinal angiography differ from those obtained from a CT angiogram of the spine or an MR angiogram of the spine. CT and MR modalities can often be used as screening tools for blood vessel disease but spinal angiography is usually the procedure of choice because MR angiography cannot detect aneurysms below 2-3 mm in size. Angiograms are performed emergently for patients with bleeding from vessels within the spinal area, e.g. sub-arachnoid hemorrhage. Routine angiograms are performed in the work up of spinal aneurysms, arteriovenous-malformations, or fistulae and vascular tumors of the spine.

Procedure

A spinal angiogram provides a roadmap of the blood vessels of the spine. A small tubed catheter, similar to a long piece of spaghetti, is placed in through an artery in the groin area. During the process of catheter placement patients will be given local anesthesia and sedation medication to keep them comfortable. If patients are unable to co-operate with the study then it may be necessary to have a general anesthetic. From the groin the catheter is navigated under image guidance up to the vessels of the spine. Once the catheter has been stabilized then contrast dye is allowed to flow through the catheter for a short period. While the dye is moving through the blood vessels a special x-ray camera or fluoroscope takes pictures of the blood vessels. As necessary, smaller micro-catheters can be introduced co-axially through the larger catheter if more detailed pictures are needed.

Spinal angiography is a fairly lengthy procedure due to the number of vessels that need to be injected. A typical procedure time is 3-4 hours. At the end of the angiogram all catheters are removed and direct pressure is held over the groin puncture until bleeding has stopped. Patients are then closely monitored in a recovery area for 4-6 hours.