Authors: A A Dawkins A L Evans J Wattam C A J Romanowski D J A Connolly T J Hodgson S C Coley
Publish Date: 2007/06/27
Volume: 49, Issue: 9, Pages: 753-759
Abstract
Cerebral angiography is an invasive procedure associated with a small but definite risk of neurological morbidity In this study we sought to establish the nature and rate of complications at our institution among a large prospective cohort of consecutive patients Also the data were analysed in an attempt to identify risk factors for complications associated with catheter angiographyData were prospectively collected for a consecutive cohort of patients undergoing diagnostic cerebral angiography between January 2001 and May 2006 A total of 2924 diagnostic cerebral angiography procedures were performed during this period The following data were recorded for each procedure date of procedure patient age and sex clinical indication referring specialty referral status routine/emergency operator angiographic findings and the nature of any clinical complication or asymptomatic adverse event arterial dissectionClinical complications occurred in 23 079 of the angiographic procedures 12 041 significant puncturesite haematomas 10 034 transient neurological events and 1 nonfatal reaction to contrast agent There were no permanent neurological complications Asymptomatic technical complications occurred in 13 044 of the angiographic procedures 3 groin dissections and 10 dissections of the cervical vessels No patient with a neck dissection suffered an immediate or delayed stroke Emergency procedures P = 00004 and angiography procedures performed for intracerebral haemorrhage P = 002 and subarachnoid haemorrhage P = 004 were associated with an increased risk of complicationsNeurological complications following cerebral angiography are rare 034 but must be minimized by careful case selection and the prudent use of alternative noninvasive angiographic techniques particularly in the acute setting The low complication rate in this series was largely due to the favourable case mix
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