Complications of Diagnostic Cerebral Angiography: Evaluation of 19 826 Consecutive Patients<sup>1</sup>

Kaufmann, Timothy J.; Huston, John; Mandrekar, Jay; Schleck, Cathy D.; Thielen, Kent R.; Kallmes, David F.

doi:10.1148/radiol.2433060536

Cited by 547 publications

(343 citation statements)

References 14 publications

(22 reference statements)

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“…As advancements in endovascular technology have been made by way of new catheter design, novel embolization materials, new contrast media, and in- creased technical experience, the overall complications of CA have continued to decrease. 13,19,23 Although increased use of noninvasive imaging modalities such as MR angiography and CT angiography have decreased the use of angiography as a diagnostic tool, many other factors continue to increase the use of CA as a therapeutic tool.…”

Section: Discussionmentioning

confidence: 99%

“…Risk factors for these complications among adults have been identified to include age greater than 55 or 65 years, atherosclerotic disease, hypertension, use of multiple catheters, use of larger access catheters, contrast load, and duration of procedure. 5,[7][8][9]19,34 Identification of these risk factors has provided guidelines for optimizing patient selection and minimizing the complications of CA in adults. These studies also enable accurate counseling of adult patients.…”

Section: Discussionmentioning

confidence: 99%

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Complications of cerebral angiography in children younger than 3 years of age

Hoffman¹,

Santillán²,

Rotman³

et al. 2014

PED

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Object The therapeutic potential for cerebral angiography (CA) in young children is expanding. However, its use in this patient population is limited by presumed higher complication rates among children. Therefore, to improve the accuracy of counseling of the parents/guardians of these patients and to identify modifiable risk factors, the authors evaluated complications after CA in young children. Methods The authors reviewed data for 309 consecutive cerebral angiograms obtained in 87 children younger than 36 months of age from 2004 to 2010 at a single institution. They analyzed demographics, diagnosis, angiographic findings, and complications. Results The patient population comprised 40 boys and 47 girls; mean age was 14.36 months (range 1–36 months) and mean weight was 10.8 kg (range 3.7–21.0 kg). For 292 of the 309 procedures, intraarterial chemotherapy was administered; the remaining 17 procedures were for vascular malformations, stroke, tumor embolization, and intracranial hemorrhage. The rate of neurological complications was 0.0%. The rate of nonneurological complications was 2.9%: 7 cases of contrast allergy or bronchospasm, 1 groin hematoma (body weight 7 kg), and 1 transient femoral artery occlusion (body weight 10.8 kg). The rate of radiographic complications was 1.3%: 1 case of transient asymptomatic intraarterial dissection and 3 cases of asymptomatic vasospasm. Postprocedural MRI was performed for 33.3% of patients with no evidence of ischemia. There were no delayed complications. Mean follow-up time was 16.6 months. No association was found between complications and age, duration of anesthesia, number of vessels catheterized, size of the sheath, or diagnostic versus interventional procedures. Despite a trend toward a higher rate of complications for patients who weighed less than 15 kg, this finding was not significant (p = 0.35). Conclusions The rate of complications for CA in young children is comparable to rates reported for older children and lower than rates reported for adults. When appropriately indicated, CA should not be omitted from the therapeutic strategy of children younger than 36 months of age.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Complications of cerebral angiography in children younger than 3 years of age

Hoffman¹,

Santillán²,

Rotman³

et al. 2014

PED

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show abstract

“…The angiography is the traditional and gold-standard method for cerebrovascular assessment in symptomatic individuals, but due to its high cost 18 , elevated risk of CVA and other complications 39 , the exclusive use of noninvasive assessment has been defended 19 .…”

Section: Discussionmentioning

confidence: 99%

Prevalência de estenose carotídea em pacientes com indicação de cirurgia de revascularização miocárdica

Rosa¹,

Portal²

2010

Arq. Bras. Cardiol.

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“…However, DSA is invasive and not without possible complications; morbidity of 0.03% and mortality of 0.06% have been reported for patients undergoing diagnostic cerebral angiography. 8,9 The requirement of injection of iodinated contrast material for DSA exposes patients and medical staff to radiation and precludes its use in patients allergic to these materials. Therefore, a noninvasive, reliable method is needed for the appropriate selection of patients with DAVF with high risk (aggressive symptoms) and the exclusion of patients with DAVF considered benign.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Intracranial Dural Arteriovenous Fistulas: Comparison of Unenhanced 3T 3D Time-of-flight MR Angiography with Digital Subtraction Angiography

Azuma

Hirai

Shigematsu

et al. 2015

MRMS

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Purpose: We compared gross characterization of intracranial dural arteriovenous fistulas (DAVFs) between unenhanced 3-tesla 3-dimensional (3D) time-of-flight (TOF) magnetic resonance angiography (MRA) and digital subtraction angiography (DSA).Methods: We subjected 26 consecutive patients with intracranial DAVF to unenhanced 3T 3D TOF MRA and to DSA. Two independent sets of observers inspected the main arterial feeders, fistula site, and venous drainage pattern on MRA and DSA images. Interobserver and intermodality agreements were assessed by k statistics.Results: Interobserver agreement was excellent for fistula site (¬ = 0.919; 95% confidence interval [CI], 0.805 to 1.000), good for main arterial feeders (¬ = 0.711; 95% CI, 0.483 to 0.984), and very good for venous drainage (¬ = 0.900; 95% CI, 0.766 to 1.000). Intermodality agreement was excellent for fistula site (¬ = 0.968; 95% CI, 0.906 to 1.000) and good for main arterial feeder (¬ = 0.809; 95% CI, 0.598 to 1.000) and venous drainage (¬ = 0.837; 95% CI, 0.660 to 1.000).Conclusion: Gross characterization of intracranial DAVF was similar for both imaging modalities, but unenhanced 3T 3D TOF MRA cannot replace DSA.

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Complications of Diagnostic Cerebral Angiography: Evaluation of 19 826 Consecutive Patients¹

Abstract: In this review, diagnostic catheter cerebral angiography was found to have relatively low complication rates.

Cited by 547 publications

References 14 publications

Complications of cerebral angiography in children younger than 3 years of age

Complications of cerebral angiography in children younger than 3 years of age

Prevalência de estenose carotídea em pacientes com indicação de cirurgia de revascularização miocárdica

Evaluation of Intracranial Dural Arteriovenous Fistulas: Comparison of Unenhanced 3T 3D Time-of-flight MR Angiography with Digital Subtraction Angiography

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Complications of Diagnostic Cerebral Angiography: Evaluation of 19 826 Consecutive Patients1

Abstract: In this review, diagnostic catheter cerebral angiography was found to have relatively low complication rates.

Cited by 547 publications

References 14 publications

Complications of cerebral angiography in children younger than 3 years of age

Complications of cerebral angiography in children younger than 3 years of age

Prevalência de estenose carotídea em pacientes com indicação de cirurgia de revascularização miocárdica

Evaluation of Intracranial Dural Arteriovenous Fistulas: Comparison of Unenhanced 3T 3D Time-of-flight MR Angiography with Digital Subtraction Angiography

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Complications of Diagnostic Cerebral Angiography: Evaluation of 19 826 Consecutive Patients¹