Cerebral four Vessel Angiography is the procedure to visualize the vessels of the Brain. It is called "four vessel"because there are four main arteries suppling blood to the brain. i.e 2 Vertebral Arteries (Rt and Lt) and 2 Carotids (Left and Right)
To perform the cerebral angiography the femoral artery is punctured to introduce the catheter into it. Catheter is pushed forward from the femoral artery to the descending aorta > Arch of aorta > Brachiocephalic Artery > Rt Carotid artery CONTRAST is introduced into this vessel electronically or manually and high frames sequences of the flouroscopy are obtained. Catherter is pushed slightly backwards into the Brachiocephalic Artery and then moved into Rt.Subclavian artery. From the Rt.Subclavian artery Rt Vertebral artery is approaced and Hight flow rate contrast is injected. Most of the Radiologist give contrast only in one of the vertebral artery so that the contrast after going into Basillar artery also opacify the Lt.Vertebral Artery. High Frame Rate Flouroscopic images are obtained to visualise the posterior blood supply of the brain.
Catherter is puled backward to arch of aorta and then introduced into the Lt.Common Carotid Artery. High Speed contrast is injected and high frame flouroscopic Images are obtained. After Completing this catheter is pulled out side and sheath present in the femoral artery is rem
oved.
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