This test provides a detailed picture of your spine’s arteries, veins, and blood vessels.
If you’ve been diagnosed with spinal cancer, your doctor may order a procedure called angiography. This imaging test shows the vascular elements of your spine—the veins, arteries, and smaller blood vessels—in sharp detail. Angiography (or an angiogram) of your spine can help your doctor in a variety of ways: It can locate the spinal tumor, show the blood vessels feeding the tumor, and can help your doctor prepare a safe removal of a tumor located near many blood vessels as well as show the location of normal vessels in that location.
What is Spinal Angiography?
Spinal angiography can be diagnostic and interventional. It can be used to help your doctor understand the current state of your spinal tumor (diagnostic) and provide minimally invasive treatment (interventional) to facilitate safe removal of the tumor.
During spinal angiography, a specialized doctor called a neuroangiographer or interventional neuroradiologist uses x-ray technology to take extremely detailed, 3D images of the blood vessels, arteries, and veins around your spinal cord. If your spinal tumor is surrounded by many blood vessels, this test will help your doctor plot a safe course of treatment that prevents excessive blood loss during surgical removal of the tumor.
Prior to the angiogram, your doctor will give you specific instructions on how to prepare for the procedure (such as when you should stop eating and drinking) as well as discuss the potential risks and benefits. There is always a small risk of complications such as bleeding or stroke but in skilled hands, the benefits far outweigh the risks.
A spinal angiogram is a minimally invasive procedure typically performed in an outpatient setting—that is, you will go home the same day as the test. You should ask a loved one to accompany you the procedure and give you a ride home.
Why Will Your Doctor Recommend Spinal Angiography?
Your doctor may order a spinal angiogram to learn more about your spinal tumor. In cases of spinal cancer, angiography is often used to help your surgeon understand if your spinal tumor is surrounded by a lot of vascular structures, such as veins, arteries, and blood vessels.
Knowing the extent of these vascular elements around your spinal tumor will help your surgeon prevent any complications during surgery, namely significant blood loss.
Based on the results of your angiogram, your surgeon can develop a plan to safely remove your spinal tumor. Sometimes during the angiogram, the neuroradiologist can clot some of the big tumor vessels to reduce bleeding during the surgery. This is usually discussed with you before proceeding but is common in certain type of tumors, such as those that travel from the kidney to the spine.
What to Expect During a Spinal Angiogram
Spinal angiography is typically performed under light sedation, though some people may require general anesthesia (often due to a separate medical condition).
Before the procedure begins, you will receive pain medication through an intravenous (IV) line. Spinal angiography uses a catheter (a thin, bendable tube) to deliver a contract medium, or dye, into your body. This dye allows your doctor to see the blood vessels, arteries, and veins during the procedure. The catheter is inserted into an artery in your leg through a small incision, and the incision area will be numbed so you won’t feel any pain.
The neuroangiographer uses x-ray technology to guide the catheter to the spinal blood vessels. Once the catheter reaches the spinal area, the dye is injected, which illuminates the blood vessels, arteries, and veins. You may feel a warming sensation as the dye enters your body. Once the dye highlights the vascular structures, the neuroangiographer captures multiple images from different angles. Your neuroangiographer will watch the images appear on a screen as the procedure is performed.
Depending on how much of your spine is observed, your angiogram may take one hour to several hours long. Once the angiogram is finished, your doctor will remove the catheter and close the artery by putting pressure on the incision site manually (with his or her hands) or using a small plug.
You won’t be able to go home immediately following the spinal angiogram, as you will need to lie flat for a few hours of observation. Make sure to tell your medical team if you notice any pain, bleeding, or swelling at the catheter site before you go home.
Benefits and Risks of Spinal Angiography
Spinal angiography is a safe and effective procedure, and complications rarely occur.
The primary benefit of spinal angiography is it provides extremely sharp and detailed images of the blood vessels, arteries, and veins in your spine. This allows your doctor to create a safe surgical plan that reduces unnecessary bleeding and other complications.
Other spinal angiography benefits include:
- It’s a minimally invasive procedure
- As it’s typically performed in an outpatient clinic, you may go home the same day.
As with any medical procedure, spinal angiography has risks. Complications are rare and may include:
- An allergic reaction to the dye
- Catheter-related problems (stroke caused by a blood clot around the catheter tip or catheter-related vessel wall injury)
- Delayed bleeding at the catheter incision site after the procedure
While the risk of these complications is low, it’s important to have a discussion with your doctor to cover all benefits and risks that may apply specifically to you.
If you’re faced with spinal cancer, your treatment plan should be as comprehensive and safe as possible. A spinal angiogram provides your surgeon a unique understanding of your spinal tumor by illuminating the key blood vessels, arteries, and veins surrounding it. With that knowledge, your doctor can develop a treatment plan that minimizes complications and gives you the best chance for a healthy recovery.