A practical guide to post-mortem selective cervical angiography in a regional institution

Area of Science:

• Forensic Pathology
• Vascular Imaging
• Medical Investigation

Background:

• Cervicocerebral dissection syndrome (CDS) necessitates arterial investigation to determine cause of death.
• Proximal common carotid arteries (CCA) are accessible, but vertebral arteries (VA) pose post-mortem (PM) assessment challenges.
• Existing institutional constraints include reliance on general hospital radiology and a 24-hour body release expectation.

Purpose of the Study:

• To describe the indications for post-mortem selective cervical angiography (PM-SCA).
• To detail a time-efficient and flexible PM-SCA method suitable for non-specialized facilities.
• To outline imaging findings and problem-solving strategies for PM-SCA.

Main Methods:

• Selective catheterization and contrast injection into cervical arteries.
• Radiographic visualization of the common carotid arteries (CCA) and vertebral arteries (VA).
• Adaptation of the procedure for limited radiological resources and time constraints.

Main Results:

• PM-SCA successfully visualizes cervicocerebral arteries, including challenging VA.
• The described method is adaptable to general hospital radiology departments.
• The technique addresses the need for rapid assessment within 24-hour body release timelines.

Conclusions:

• PM-SCA is a valuable tool for investigating cervicocerebral dissection syndrome when VA assessment is required.
• The described method offers a practical solution for institutions without dedicated PM radiological facilities.
• This approach enhances post-mortem examination capabilities for vascular pathologies.