Carotid and Vertebral Arteriography

  • Muneer Eesa


With rapid advancements in noninvasive vascular imaging, the use of conventional catheter angiography for the diagnostic evaluation of diseases of the carotid and vertebral arterial vasculature has shown a steady decline over time. Cross-sectional imaging modalities and other noninvasive techniques for vascular diagnosis are less prone to some of the risks associated with the invasive nature of catheter angiography and less prone to operator techniques and experience. Certain patients with severe allergic reaction to iodinated contrast may be imaged with unenhanced MRI techniques and Doppler ultrasound. However, there remain unique situations where invasive catheter angiography can be invaluable in evaluation of extracranial carotid and vertebral disease and can be a useful problem-solving tool. Some common indications for arteriography of the extracranial carotid and vertebral arteries include conditions such as steno-occlusive disorders commonly due to atherosclerotic vascular disease; evaluation of aneurysms and vascular malformations of the head and neck, including upper cervical spinal vascular lesions; pre-therapeutic evaluation of vascular tumors; and balloon test occlusion prior to vessel sacrifice or surgical exploration.


Angiography Carotid disease Aneurysm Rotational angiography Vascular malformation Carotid body tumor Spinal vascular malformation Catheter angiography 


  1. 1.
    Moniz E. L’encephalographie arterielle, son importance dans la localisation des tumeurs cerebrales. Rev Neurol (Paris). 1927;2:72–90.Google Scholar
  2. 2.
    Tondreu R. Egas Moniz 1874–1955., Father of cerebral angiography, father of psychosurgery, neurologist and psychiatrist, politician and diplomat, Nobel laureate. Radiographics. 1985;5:994–7.CrossRefGoogle Scholar
  3. 3.
    Seldinger SI. Catheter replacement of the needle in percutaneous arteriography; a new technique. Acta Radiol. 1953;39:368–76.CrossRefGoogle Scholar
  4. 4.
    List CF, Hodges FJ. Angiographic diagnosis of expanding intracranial lesions by vascular displacement. Radiology. 1946;47(4):319–33.CrossRefGoogle Scholar
  5. 5.
    Radner S. Intracranial angiography via the vertebral artery. Preliminary report on a new technique. Acta Radiol. 1947;28:838–42.CrossRefGoogle Scholar
  6. 6.
    Dawbarn R. The starvation plan for malignancy in the external carotid area. JAMA. 1904;43:792–5.CrossRefGoogle Scholar
  7. 7.
    Luessenhop AJ, Spence WT. Artificial embolization of cerebral arteries. Report of use in a case of arteriovenous malformation. JAMA. 1960;172:1153–5.CrossRefGoogle Scholar
  8. 8.
    Day AL, Siddiqui AH, Meyers PM, Jovin TG, Derdeyn CP, Hoh BL, et al. Training standards in neuroendovascular surgery: program accreditation and practitioner certification. Stroke. 2017;48(8):2318–25.CrossRefGoogle Scholar
  9. 9.
    Brinjikji W, Demchuk AM, Murad MH, Rabinstein AA, McDonald RJ, McDonald JS, et al. Neurons over nephrons: systematic review and meta-analysis of contrast-induced nephropathy in patients with acute stroke. Stroke. 2017;48(7):1862–8.CrossRefGoogle Scholar
  10. 10.
    Brigida R, Misciasci T, Martarelli F, Gangitano G, Ottaviani P, Rollo M, et al. Rays. 2003;28(1):21–8.PubMedGoogle Scholar
  11. 11.
    Mokin M, Snyder KV, Levy EI, Hopkins LN, Siddiqui AH. Direct carotid artery puncture access for endovascular treatment of acute ischemic stroke: technical aspects, advantages, and limitations. J Neurointerv Surg. 2015;7(2):108–13.CrossRefGoogle Scholar
  12. 12.
    Yousem DM, Trinh BC. Injection rates for neuroangiography: results of a survey. AJNR Am J Neuroradiol. 2001;22(10):1838–40.PubMedGoogle Scholar
  13. 13.
    Geyik S, Yavuz K, Akgoz A, Koc O, Peynircioglu B, Cil B, et al. The safety and efficacy of the Angio-Seal closure device in diagnostic and interventional neuroangiography setting: a single-center experience with 1,443 closures. Neuroradiology. 2007;49(9):739–46.CrossRefGoogle Scholar
  14. 14.
    Jang DK, Stidd DA, Schafer S, Chen M, Moftakhar R, Lopes DK. Monoplane 3D overlay roadmap versus conventional biplane 2D roadmap technique for Neurointervenional procedures. Neurointervention. 2016;11(2):105–13.CrossRefGoogle Scholar
  15. 15.
    Mehndiratta A, Rabinov JD, Grasruck M, Liao EC, Crandell D, Gupta R. High-resolution dynamic angiography using flat-panel volume CT: feasibility demonstration for neuro and lower limb vascular applications. Eur Radiol. 2015;25(7):1901–10.CrossRefGoogle Scholar
  16. 16.
    Willinsky RA, Taylor SM, TerBrugge K, Farb RI, Tomlinson G, Montanera W. Neurologic complications of cerebral angiography: prospective analysis of 2,899 procedures and review of the literature. Radiology. 2003;227(2):522–8.CrossRefGoogle Scholar
  17. 17.
    Ota S, Sekihara Y, Himeno T, Tanaka Y, Ohtonari T. Contrast-less stent placement for vertebral artery origin stenosis. Interv Neuroradiol. 2017;23(1):79–83.CrossRefGoogle Scholar

Copyright information

© The Author(s) 2018

Authors and Affiliations

  • Muneer Eesa
    • 1
  1. 1.Department of Radiology, Foothills Medical CenterUniversity of CalgaryCalgaryCanada

Personalised recommendations