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Incidence of Silent Ischemic Infarct after Diagnostic Conventional Cerebral Angiogram

Fawaz Al-Hussain1, Bandar Aljafen1, Adel Alhazzani1

  • 1Department of Internal Medicine, Faculty of Neurology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
|March 29, 2021
PubMed

Insights

Diagnostic cerebral angiograms carry a risk of new ischemic events, detectable by diffusion-weighted MRI. Fluoroscopy time, operator experience, and vascular risk factors influence silent cerebral ischemia after the procedure.

Area of Science:

  • Neurology
  • Radiology
  • Cardiovascular Science

Background:

  • Cerebral angiography is a common diagnostic procedure.
  • The risk of ischemic events following angiography requires further investigation.
  • Diffusion-weighted MRI (DW-MRI) can detect new ischemic lesions.

Purpose of the Study:

  • To assess the risk of new ischemic events after diagnostic cerebral angiograms.
  • To identify factors contributing to silent cerebral ischemia.

Main Methods:

  • Systematic literature search of prospective studies (1999-2019).
  • Inclusion criteria: diagnostic angiogram before MRI, pre- and post-angiogram DW-MRI, documented new lesions.
  • Analysis of data from six eligible studies involving 430 angiograms.

Main Results:

  • New diffusion-weighted imaging (DWI) lesions were detected in 24.65% (106/430) of diagnostic angiograms.
  • Independent risk factors for silent cerebral ischemia included mean fluoroscopy time, procedure by a resident operator, and patient vascular risk factors.

Conclusions:

  • Diagnostic cerebral angiograms are associated with a significant risk of new ischemic events.
  • Fluoroscopy time, operator experience, and vascular risk factors are key predictors of post-angiogram silent cerebral ischemia.

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