What is spinal angiography?
Spinal angiography is a procedure by which extremely detailed images of spine vasculature (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 best visualized.
How is spinal angiography done?
In some respects, spinal angiography is similar to other angiographies with which patients may be more familiar, such as for example cardiac catheterization. Similar to a cardiac cath, a catheter is inserted into an artery in the leg (usually) and guided under x-rays into individual arteries which supply the spinal cord and adjacent bone, muscle and other tissues. A picture of each artery is taken separately. This is done under x-rays. There are many arteries going to the spinal area, corresponding to the vertebra (bones which make up the spine). Unlike cardiac catheterization, spinal angiography is usually done under anesthesia to obtain the best possible images and for patient comfort. Depending on the purpose, a spinal angiogram may require images of only a few arteries, or the whole spinal axis. 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 devices other than stents, such as coils or glue-type substances, to treat disease.
What are the indications (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. Please see this link for dedicated information regarding this disease.
Sometimes, spinal angiography is being 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 — much less common than brain stroke, but typically having unfavorable outcome. We may be asked to prove that a patient had spinal stroke, or even try to reverse the stroke by opening a blocked artery. Unlike in the brain, where quick opening of blocked arteries can lead to miraculous recoveries, spinal strokes carry a worse prognosis.
What to expect if you are having spinal angiography?
That depends on where you have one. Expectations at our institution are going to sleep and waking up several hours later when the procedure is done, recovering from anesthesia, and going home the same day or next in case of spinal angiography alone. When angiography is combined with embolization (treatment), the time in hospital and recovery process depend on the disease being treated.
Does health insurance pay for spinal angiography (applies to United States patients only)?
So far, usually yes, depending on what it is done for. A pre-authorization is typically required. Spinal angiography is a relatively expensive diagnostic procedure.
Where to have spinal angiography?
Spinal angiogrpahy is a highly specialized diagnostic procedure. Centers performing the procedure should have sufficient volume (do enough angiograms) to be familiar with spinal anatomy and various diseases. Our center at NYU Langone performs a very high number of spinal angiograms.
Additional information, more immediately patient-centered, is found in the Patient information Section dealing with conditions of Spinal Dural Fistula, Spinal Metameric AVM and others. Also you may want to see Introduction to Spinal Angiography page.
Questions / Referrals: For questions, or to refer a patient for spinal angiography consultation, you can contact us using the Contact Us page or calling the office at 212-263-6008