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Safety of diagnostic spinal angiography in children
Ayushi Gautam1, Mina Motaghi1, Philippe Gailloud2
1Div Interventional Neuroradiology, Johns Hopkins Hospital, Baltimore, Maryland, USA.
Insights
Pediatric spinal angiography (SA) is safe, with no complications reported in this large cohort. This study confirms SA can be performed in children with low contrast and radiation exposure.
Area of Science:
- Pediatric radiology
- Interventional neuroradiology
- Vascular imaging
Background:
- Safety of spinal angiography (SA) in children remains under-analyzed.
- This study aimed to assess the safety of pediatric SA.
Observation:
- Retrospective analysis of 36 SA procedures in 27 children (average age 11.1 years).
- Included 24 diagnostic and 12 combined therapeutic cases.
- Analyzed neurological/non-neurological complications, contrast volume, and radiation exposure.
Findings:
- No neurological or non-neurological complications requiring intervention were observed.
- Average contrast volume was 1.6 mL/kg (diagnostic) and 0.9 mL/kg (therapeutic).
- Average air kerma was 186.9 mGy (diagnostic) and 264.5 mGy (therapeutic), with higher exposure in the combined group due to fluoroscopy.
Implications:
- This study represents the largest pediatric SA cohort to date, including radiation and contrast data.
- Pediatric SA is a safe imaging modality with a low complication risk.
- SA can be safely performed in children, utilizing low radiation doses and contrast volumes.
Background:
Spinal angiography (SA) is associated with low complications in adults but its safety in children has not been properly analyzed. The goal of our study is to assess the safety of pediatric SA.
Methods:
This study is the retrospective analysis of a series of 36 consecutive SA procedures performed in 27 children over a 5-year period. Parameters including neurological complications, non-neurological complications requiring additional management, contrast volume, and radiation exposure were analyzed via univariate and bivariate methods.
Results:
Our cohort included 24 diagnostic and 12 combined therapeutic cases in children with an average age of 11.1 years. No neurological or non-neurological complication requiring additional management was recorded. The average volume of contrast administered was 1.6 mL/kg in the diagnostic group and 0.9 mL/kg in the combined group. The average air kerma was 186.9mGy for an average of 36.8 exposures in the diagnostic group, and 264.5mGy for an average of 21 exposures in the combined group. Patients in the combined group had lower contrast load (45% lower on average) and higher air kerma (1.6 times higher on average). The difference in air kerma was due to a higher live fluoroscopy-related exposure.
Conclusions:
This study reports the largest pediatric SA cohort analyzed to date and the only one including radiation dose and contrast load. It confirms that pediatric SA is a safe imaging modality with low risk of complications, and demonstrates that SA can be performed in children with low radiation exposure and contrast load.
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