[Risk factors of cerebral aneurysm re-rupture during angiography]

Although re-rupture of cerebral aneurysm during angiography has been reported occasionally, we have encountered 13 such patients during eight years since 1974, the incidence corresponding to 4.4 percent of 295 consecutive aneurysm patients on whom a total of 467 angiographies were performed. Extravasation on angiogram was noticed in 10 of these patients. We carefully analyzed the following factors to determine which one is significantly related to aneurysm re-rupture during cerebral angiography. The factors we investigated were sex, age, sites of ruptured aneurysm, surgical risk grade and time interval between the latest rupture of aneurysm and angiography. Our procedures of angiography were standardized as such that contrast material was injected by means of power injector and the injection pressure was adjusted at 2.5 kg/cm2 in vertebral angiography, 3 kg/cm2 in carotid angiography and 4 kg/cm2 in retrograde brachial angiography. Volume of contrast material was 6-8 ml, 10-12 ml and 30-32 ml, respectively. An incidence of re-rupture during angiography when performed within the initial 24 hours after the latest bleeding episode was 12 out of 123 angiographies (9.8%), whereas 1 out of 344 angiographies (0.3%) which were performed later than 24 hours. This difference was significant (p less than 0.001). These data were further analyzed every one hour period. It was learned that re-rupture rate was significantly high, 9 out of 45 patients (20.0%) when angiography was done within 5 hours after the latest aneurysm rupture (p less than 0.01), particularly, 8 out of 27 patients (29.6%) within 3 hours (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)