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Complications of diagnostic cerebral angiography: evaluation of 19,826 consecutive patients
Timothy J Kaufmann1, John Huston, Jay N Mandrekar
1Department of Radiology, Mayo Clinic, Mayo E2, 200 1st St SW, Rochester, MN 55905, USA. Kaufmann.timothy@mayo.edu
Insights
Diagnostic cerebral catheter angiography has low complication rates, with neurologic complications in 2.63% of patients. Risk factors include cerebrovascular disease and subarachnoid hemorrhage, while procedural year and trainee involvement decrease risk.
Area of Science:
- Neurology
- Radiology
- Vascular Medicine
Background:
- Cerebral catheter angiography is a key diagnostic tool.
- Understanding its complication profile is crucial for patient safety and procedural optimization.
Purpose of the Study:
- To retrospectively evaluate the complication rates of diagnostic cerebral catheter angiography.
- To identify patient and procedural factors associated with neurologic complications.
Main Methods:
- Retrospective review of 19,826 consecutive patients undergoing diagnostic cerebral angiography from 1981-2003.
- Data collection included demographic, procedural, and complication information.
- Multivariable analysis was used to identify risk factors for neurologic complications.
Main Results:
- Overall complication rate was low, with neurologic complications in 2.63% of examinations (0.14% permanent disability strokes) and 0.06% mortality.
- Access-site hematoma was the most common complication (4.2%).
- Increased risk of neurologic complications was associated with atherosclerotic cerebrovascular disease, subarachnoid hemorrhage, and frequent transient ischemic attack; trainee involvement and increasing procedural year were associated with decreased risk.
Conclusions:
- Diagnostic cerebral catheter angiography demonstrates a favorable safety profile with relatively low complication rates.
- Risk stratification and procedural improvements have contributed to enhanced patient safety over time.
Purpose:
To retrospectively evaluate the complications of diagnostic cerebral catheter angiography in 19,826 consecutive patients.
Materials And Methods:
This HIPAA-compliant study had institutional review board approval, with waiver of informed consent. Demographic, procedural, and complication data in 19 826 consecutive patients undergoing diagnostic cerebral angiography at one institution from 1981 through 2003 were retrospectively reviewed. Neurologic, systemic, and local complications were recorded on the basis of clinical follow-up results after each angiographic examination. Events that occurred within 24 hours of angiography were considered to be complications of the procedure. Multivariable analysis was employed to identify patient and procedural factors significantly associated with neurologic complications.
Results:
Neurologic complications occurred in 522 examinations (2.63%), and 27 of these (0.14%) were strokes with permanent disability. Twelve deaths occurred (0.06%). Access-site hematoma was the most common complication overall (4.2%). Factors independently associated with an increased risk of neurologic complication included the indication of atherosclerotic cerebrovascular disease (odds ratio [OR], 2.494), the indication of subarachnoid hemorrhage (OR, 2.523), and the comorbidity of frequent transient ischemic attack (OR, 1.674). Factors independently associated with a decreased risk of neurologic complication were increasing chronologic year in which the procedure was performed (OR, 0.659 per 5-year interval) and involvement of a trainee in the procedure (OR, 0.710).
Conclusion:
In this review, diagnostic catheter cerebral angiography was found to have relatively low complication rates.
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