The carotid arteries are located in your neck and carry blood to your brain. As you get older, they can narrow and reduce the flow of blood to your brain. Early signs can warn you of carotid artery disease. These include light strokes or transient ischemic attacks (TIA's), carotid bruit and strokes. TIA's are caused by a brief reduction in blood flow to the brain. Symptoms last just a few minutes and may include numbness, weakness and difficulties with speech or vision. Carotid bruit is the sound blood makes when it rushes through partially blocked arteries. Strokes occur when the brain is deprived of blood because of a prolonged blockage in the carotid artery or one of its branches.

Preparation
After you and your physician have discussed the procedure, you will be asked to sign a consent form. Please read it carefully and ask any questions you have.

Do not eat or drink anything after midnight the night before the procedure. If you are diabetic, please let our schedulers know.

An intravenous needle will be placed in your arm. Blood may be drawn for use in laboratory tests and you will receive medication to help you relax.

Carotid arteriograms are performed in a specially equipped hospital laboratory by a carefully trained staff. Your family will wait for you in a nearby room.

The Procedure
The procedure requires about an hour. You will be awake, but sedated and comfortable. The cardiologist and lab staff will explain each step of the procedure. If you have questions at any time, please ask.

The area of the insertion will be scrubbed. You will be covered with sterile sheets and the area will be numbed with a local anesthetic. You will feel pressure during the procedure but you should not feel any pain.

The cardiologist will place a catheter into a blood vessel from a site in your groin area and maneuver it into place to allow for testing. Tests include x-rays of the carotid artery.

A contrast solution will be injected through the catheter into your carotid artery. You may feel a warm or hot sensation during the injection but it should last only about 30 seconds. If you experience any pain, please tell the physician or nurse. It's very important to lie very still during the procedure.

Your cardiologist will view images of your carotid artery on nearby monitors. After the catheter is removed, firm pressure will be applied to the insertion site to help form a seal over the puncture in the artery.

Following the Procedure
A dressing and five-pound sandbag may be placed over the insertion site and you will be asked to lie flat for about four hours. At that time, you will be allowed to roll to your side and the sandbag can be removed.

Your IV will remain in place for most of the day and your heart rate, blood pressure and the insertion site will be monitored regularly. You will be allowed to eat and drink as soon as you feel comfortable.

You will continue to receive intravenous fluids and you will be encouraged to drink fluids to help flush the contrast solution from your kidneys. A nurse will assist you when you feel ready to get out of bed. You may feel dizzy or lightheaded.

In some cases, you may be allowed to return home and resume restricted activity later the same day. In other cases, you may remain in the hospital or a nearby hotel overnight.

You may continue to have a bruise, swelling and tenderness at the insertion site. Do not lift anything over 10 pounds for a week after the procedure.

Before you leave, your physician will discuss the results of the test and explain your treatment plan with you.