[A study of intraarterial pressure changing during cerebral angiography]

Elevation of cerebral blood pressure induced by injection of contrast medium has been postulated as a major cause of rerupture of cerebral aneurysms during angiography. The current study was performed to clarify whether intra-arterial pressure elevation occurs during contrast injection.

The study included six patients. To confirm the accuracy of pressure measurement, a pressure wire (SmartWire) was used. The changes in intravascular pressure were measured by the pressure wire and through a microcatheter and a guiding catheter The data from these modalities were then compared. The contrast injection flow rate was 4 ml/s in ICAG (internal carotid angiography), 3 ml/s in VAG (vertebral angiography) and 5 ml/s in CAG (carotid angiography), and all injections were administered without contrast wedging, regurgitation or mechanical spasm in adjacent arteries.

The pressure measured through the guiding catheter was the same as that measured with the pressure wire, but the data obtained through the microcatheter was not more than reference data. The changes in pressure were not evident in the distal end of the catheter tip.

Intra-arterial pressure elevation probably doesn't occur under appropriate injection, resulting in safer cerebral angiography. However, in case a high contrast injection flow rate is required to produce a better image, surgeons should also be aware of the possibility of pressure elevation.