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Updated: Jul 14, 2026
Combined Near-infrared Fluorescent Imaging and Micro-computed Tomography for Directly Visualizing Cerebral Thromboemboli
Published on: September 25, 2016
Cerebral thromboembolic complications during cerebral angiography and their risk factors in different subgroups:
Jorge Murilo Barbosa De Sousa1,2,3,4,5, Gleyson Moraes Rios6,7,8,9, José Roberto Falco Fonseca6,10,7
1Clínica NeuroEV, Rua Botucatu, 591, Sala 104, São Paulo, SP, 04023-062, Brazil. jorgesousainr@gmail.com.
Insights
Diagnostic cerebral digital subtraction angiography (DSA) is a safe procedure with a low overall complication rate of 0.97%. Thromboembolic events and hematomas were the most common issues, occurring in 0.36% and 0.24% of cases, respectively.
Area of Science:
- Neurology
- Vascular Surgery
- Radiology
Background:
- Cerebral digital subtraction angiography (DSA) is the gold standard for diagnosing cerebrovascular diseases.
- However, DSA is invasive and carries potential risks and complication rates.
Purpose of the Study:
- To determine the frequency of neurological and non-neurological complications associated with diagnostic DSA.
- To analyze DSA complications in different disease subgroups, focusing on thromboembolic cerebral events.
Main Methods:
- Retrospective review of clinical records for adult patients undergoing DSA between January 2019 and December 2022.
- Analysis of demographic data, DSA reports, CT/MRI findings, and clinical follow-up.
Main Results:
- A total of 2,457 diagnostic DSAs were analyzed, with 24 complications (0.97%).
- Thromboembolic complications occurred in 0.36% of patients, and large hematomas (≥5 cm) in 0.24%.
- A trend for increased thromboembolic complications was observed in patients with atherosclerosis (p=0.07), while age was not a factor (p=0.93).
Conclusions:
- Diagnostic cerebral DSA procedures demonstrate low complication rates.
- The findings support the safety profile of DSA in evaluating cerebrovascular conditions.
Purpose:
Diagnostic cerebral digital subtraction angiography (DSA) is an invasive examination that involves catheterization of the major supra-aortic arterial trunks and evaluation of intracranial vessels for diagnostic purposes. Although considered the gold standard method for investigating cerebrovascular diseases, DSA carries measurable and potentially serious complication rates. This report describes the frequency of neurological and non-neurological complications of DSA performed in five hospitals in the state of São Paulo, Brazil, and analyzes them in different disease subgroups. It has a special focus on thromboembolic cerebral complications.
Methods:
We retrospectively reviewed clinical records of all adult patients who underwent DSAs between January 2019 and December 2022. Demographic variables, DSA reports, CT/MRI reports, and clinical follow-up notes were reviewed.
Results:
Twenty-four patients experienced some type of complication among 2,457 diagnostic DSAs (0.97%). Thromboembolic complications were recorded in 9 patients (0.36%), and access site hematomas larger than 5 cm were registered in six patients (0.24%). There was a statistical trend for thromboembolic complications in patients with cervical and/or intracranial atherosclerosis (p = 0.07), but age was not associated with them (p = 0.93). Patients who received heparin had lower rates of embolic complications than those who did not receive it, but there was no statistically significant difference (p = 0.17). Intravenous administration of heparin showed a trend toward significance with groin hematoma (p = 0.10).
Conclusion:
Diagnostic catheter DSAs have low complication rates.
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