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[Cerebral angiography: a study of complications in 450 consecutive procedures]
D Berteloot1, X Leclerc, D Leys
1Service de Neuroradiologie, CHRU de Lille, Hôpital R Salengro.
Insights
Modern cerebral angiography has risks, including stroke and death, particularly in patients with atherosclerosis. Non-invasive imaging may reduce these cerebral angiography complications.
Area of Science:
- Neurology
- Radiology
- Vascular Imaging
Background:
- Cerebral angiography is a key diagnostic tool for neurological conditions.
- Advancements in imaging technology aim to improve safety and efficacy.
- Assessing complication rates is crucial for patient care and procedural guidelines.
Purpose of the Study:
- To comprehensively evaluate all complications, both minor and major, linked to contemporary cerebral angiography.
- To identify patient populations at higher risk for adverse events.
- To determine if technological improvements have reduced complication rates.
Main Methods:
- Prospective analysis of 450 consecutive cerebral angiographic procedures.
- Detailed recording of all observed complications and their outcomes.
- Correlation of complications with patient demographics and underlying conditions.
Main Results:
- Overall complication rate was 2.2%, with one death (0.2%) from cholesterol embolus.
- Thromboembolic events occurred in 1.6% of patients, causing transient ischemic symptoms or permanent hemiplegia.
- Acute renal failure (0.4%) and transient arrhythmias were also noted, with most complications in stroke patients.
Conclusions:
- Morbidity and mortality rates for cerebral angiography have not decreased despite equipment advancements.
- Atherosclerosis is a primary risk factor for procedural complications.
- Optimizing patient selection and utilizing non-invasive alternatives like MR angiography or CT angiography can mitigate risks.
Purpose:
To evaluate all types of complications, both minor and major, associated with modern cerebral angiography.
Materials And Methods:
A prospective study of 450 consecutive cerebral angiographic procedures is reported.
Results:
One patient (0.2%) died from a cholesterol embolus. In seven patients (1.6%), thromboembolic events occurred within 24 hours after the procedure, leading to transient ischemic symptoms in six and permanent hemiplegia in one. Two patients suffered from acute renal failure (0.4%). Transient cardiac arrhythmias were observed in three patients without consequence on the clinical outcome. Most complications of angiography occurred in patients referred from the neurology department for work-up of stroke syndrome.
Conclusion:
Our results show that morbidity and mortality rates related to the angiographic procedure did not decrease in spite of major improvement of angiographic materiel. Atherosclerosis is the main risk factor for complication. Most of the complications could be avoided by appropriate selection of indications and by using non-invasive techniques such as magnetic resonance angiography or helical CT angiography.