Diagnostic cerebral angiography: the interventional neurology perspective

Cerebral angiography (CA) is increasingly used in clinical practice with advances in neurointerventional therapy. We present our CA experience performed by neurologists at an academic institution.

CA performed between July 2005 and March 2008 was reviewed. Major neurological outcome was defined as a new neurological deficit lasting >24 hours or worsening of pre-existing neurological deficit by 4 points on the National Institutes of Health Stroke Scale. Major non-neurological outcomes were defined as any death within 24 hours of the procedure, vascular injury requiring surgery, arteriovenous fistula, or pseudo-aneurysm formation and access site hematoma >5 cm, and/or requiring blood transfusion.

In total 661 angiograms were performed over 30 months. CA indications were ischemic stroke in 210/661 (31.7%), hemorrhagic stroke in 321/661 (48.6%), trauma for 16/661 (2.4%), presurgical epilepsy workup 95/661 (14.3%), and other conditions 19/661 (2.9%). Mean age of the group was 49 +/- 18 years. Permanent neurological deficit occurred in .2% (1 patient) and reversible neurological deficits occurred in .2% (1/661). Major non-neurological complications occurred in .9% (6/661). All these rates were less than established guidelines.

The safety and efficacy of CA performed by interventional neurologists is acceptable by current guidelines.