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Role of Neuroimaging Before Coronary Angiography in Patients With Out-of-Hospital Cardiac Arrest

Edmond Wong1, Kathryn Yu1, Davide Tomassoni1

  • 1Department of Cardiology, Eastern Health, Melbourne, Victoria, Australia.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|June 1, 2026
PubMed

Insights

Pre-angiography CT-Brain scans in out-of-hospital cardiac arrest (OOHCA) patients rarely identify brain pathology. This imaging significantly delays emergency coronary angiography procedures.

Area of Science:

  • Cardiology
  • Neurology
  • Emergency Medicine

Background:

  • Patients with out-of-hospital cardiac arrest (OOHCA) often require urgent coronary angiography.
  • Presentations may involve syncope or head trauma, prompting consideration of brain imaging.

Purpose of the Study:

  • To evaluate the clinical impact and utility of pre-coronary angiography CT-Brain (CT-B) in OOHCA patients.
  • To assess the effect of CT-B on clinical outcomes and procedural efficiency.

Main Methods:

  • Retrospective analysis of 235 OOHCA patients undergoing emergency coronary angiography.
  • Stratification into groups based on whether a CT-Brain scan was performed prior to angiography.
  • Comparison of baseline demographics, procedural times, and clinical outcomes between groups.

Main Results:

  • The CT-Brain group (n=39) was more likely to have fallen or sustained a head strike.
  • Door-to-procedure time was significantly longer in the CT-Brain group (105 min vs. 53 min).
  • No significant differences were observed in ICU length of stay or 30-day mortality; CT-B identified pathology in 17.9% of cases, rarely deferring angiography.

Conclusions:

  • Pre-angiography CT-Brain scans in OOHCA patients have a low yield for identifying significant neuropathology.
  • Performing CT-Brain scans prior to coronary angiography significantly increases door-to-procedure time without improving mortality or ICU stay.
Abstract

Keywords:
CT‐Braincardiac arrestdoor‐to‐procedure

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