Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Noninvasive cerebrovascular evaluation: a prerequisite for angiography?

E W Pollak

    American Journal of Surgery
    |August 1, 1982
    PubMed
    Summary

    Cerebrovascular angiography in unselected patients is unsafe and inefficient. Noninvasive screening accurately identifies patients needing angiography, improving yield and patient safety, thus avoiding unnecessary procedures and potential complications.

    Related Concept Videos

    You might also read

    Related Articles

    Articles linked to this work by shared authors, journal, and citation graph.

    Sort by
    Same author

    Relationship between mammographic screening intervals and size and histology of ductal carcinoma in situ.

    AJR. American journal of roentgenology·1999
    Same author

    Skull roentgenography in the evaluation of head injury.

    Southern medical journal·1983
    Same author

    Recurring cystosarcoma phyllodes associated with breast carcinoma.

    Southern medical journal·1982
    Same author

    Ventricular cardiac arrhythmias during anesthesia: feasibility of preoperative recognition.

    Southern medical journal·1982
    Same author

    Diagnosis of incipient reflux esophagitis: a new test.

    Southern medical journal·1981
    Same author

    Perineoscrotal gangrene: two-staged therapeutic approach.

    Southern medical journal·1981

    Area of Science:

    • Neurology
    • Vascular Medicine
    • Diagnostic Imaging

    Background:

    • Cerebrovascular evaluation is crucial for stroke prevention.
    • The safety and cost-effectiveness of diagnostic angiography require scrutiny.
    • The efficacy of noninvasive screening methods in guiding angiography is debated.

    Purpose of the Study:

    • To assess the safety and economic efficiency of angiography in unselected patients.
    • To determine if noninvasive screening is sensitive and effective in increasing the diagnostic yield of angiography.
    • To evaluate outcomes for patients with positive noninvasive screening results who did not undergo angiography.

    Main Methods:

    • Retrospective reassessment of cerebrovascular evaluation results in 768 patients.
    • Comparison of outcomes between patients undergoing angiography with and without prior noninvasive screening.
    • Analysis of complication rates (hemorrhage, neurologic deficit, death) associated with angiography.
    • Evaluation of cerebrovascular events in patients with positive noninvasive screening who did not receive angiography.

    Main Results:

    • Angiography in unselected patients yielded positive results in 21% and carried risks of hemorrhage (2.4%), neurologic deficit (2.2%), and death (0.2%).
    • Noninvasive screening identified 64% of patients who did not require angiography, while increasing the yield of positive angiographic findings from 21% to 74%.
    • Patients with positive noninvasive screening who forewent angiography faced a 3% mortality and 21% stroke rate over 3 years.

    Conclusions:

    • Cervicocephalic angiography in asymptomatic, unselected patients is no longer justifiable due to safety and efficiency concerns.
    • Positive noninvasive screening results must be acted upon, as delaying treatment leads to significant mortality and morbidity.
    • Noninvasive screening enhances the diagnostic utility of angiography and improves patient selection, reducing unnecessary invasive procedures.

    Related Experiment Videos