Intraoperative angiography in the management of neurovascular disorders

Intraoperative angiography is useful in verifying the goals of neurovascular operations during the procedure and before the wound is closed. We report on our technique of intraoperative angiography in 115 neurovascular operations, including obliteration of intracranial aneurysms, resection of brain and spinal arteriovenous malformations, creation of extracranial-to-intracranial bypass grafts, and carotid endarterectomy. Of these 115 procedures, intraoperative angiograms provided information that altered the operative procedure on 19 occasions. There were two complications in the 115 cases that may be related to the intraoperative angiographic procedure. Overall, however, the quality of image provided by portable digital subtraction intraoperative angiography makes this technique a safe adjunct to neurovascular surgery.