Direct percutaneous cerebral angiography in neurosurgical practice

A retrospective analysis of 1171 consecutive percutaneous retrograde brachial and carotid cerebral angiograms was performed on 635 patients, 50.7% of whom were in the sixth decade or older. Symptoms and signs of cerebrovascular disease were the most frequently investigated and diagnosed, accounting for 46.7% of all the angiograms. Despite this relatively high-risk population, we have found direct percutaneous cerebral angiography to have a very low risk. The pros and cons of direct percutaneous versus transfemoral cerebral angiography are discussed. The literature of the previous 10 years is reviewed, and the complication rate of these two techniques is compared.