What is spinal angiography?
Spinal angiography is a procedure where extremely detailed images of spinal vessels (arteries and veins) are acquired. The vessels of the spinal cord and surrounding tissues can be seen in exquisite detail, and blood flow from arteries to veins viewed in sequence.
How is spinal angiography done?
Similar to other angiographic procedures, a long, skinny hollow plastic tube called “catheter” is inserted into an artery, usually in the leg, and guided under x-rays into individual arteries which supply the spinal cord and adjacent bone, muscle and other tissues. A dye (contrast agent) is injected through the catheter, and x-ray images of the dye progressing through the arteries, tissues, and veins are taken. There are many arteries going to the spinal area and therefore spinal angiography can be a time-consuming procedure. Spinal angiography is usually done under anesthesia to obtain the best possible images and for patient comfort. Depending on the purpose for the angiogram, images of only a few or most spinal arteries may be required. Spinal angiography is often combined with treatment of whatever problem is being addressed, similar to how cardiac catheterization is combined with treating heart disease with stents and other devices. Spinal treatments typically use glue-like substances to treat disease.
What are the reasons to do spinal angiography?
A patient may need spinal angiography because they are suspected of having a problem with arteries and veins of the spinal cord. The most common such problem is a Spinal Dural Arteriovenous Fistula, or other arteriovenous shunts, such as a Spinal Pial Fistula, Spinal Epidural Fistula, or a Spinal AVM.
Sometimes, spinal angiography is requested to evaluate a patient with an unexplained problem within their spinal cord in hopes that angiography may give the answer. We evaluate these patients on individual basis to decide whether spinal angiography is indeed warranted.
Patients with tumors within and/or adjacent to the spine, such as within bones, may need surgery to remove the tumor. Some tumors are very vascular (bloody) and the surgeon may send a patient to us for pre-operative embolization of the tumor — a procedure where the arteries supplying the tumor are closed with different agents to reduce blood flow and improve surgical outcome.
Occasionally, we see patients with spinal stroke – a much less common condition than brain stroke. We may be asked to prove that a patient had spinal stroke and not some other cause for the problem. Unlike in the brain, where quick opening of blocked arteries can lead to great recoveries, spinal strokes carry a worse prognosis.
What to expect if you are having spinal angiography?
At the NYULMC, spinal angiography is done under general anesthesia. There are small but potentially important risks associated with all procedures, including spinal angiography. These vary amongst patients and should be discussed with the physician performing the procedure. Patients usually return home about 6-8 hours after diagnostic spinal angiography. When angiography is combined with embolization (treatment), the time in hospital and recovery process depend on the disease being treated; at least 1 night in the hospital is typical.
Where to have spinal angiography?
Spinal angiography is a highly specialized diagnostic procedure. Centers performing the procedure should have sufficient number of cases and experience to be familiar with spinal anatomy and various diseases.
The physicians at the Bernard and Irene Schwartz Interventional Neuroradiology Center specialize in spinal angiography and embolization of various spinal vascular conditions, where we have extensive experience. As all centers of excellence, we function as part of a group of diagnostic neuroradiologists, neurologists, neurosurgeons, and other physicians and support staff. The center can be contacted by calling 212-263-6008.