Literature DB >> 12637677

Neurologic complications of cerebral angiography: prospective analysis of 2,899 procedures and review of the literature.

Robert A Willinsky1, Steve M Taylor, Karel TerBrugge, Richard I Farb, George Tomlinson, Walter Montanera.   

Abstract

PURPOSE: To prospectively identify risk factors for neurologic complications related to cerebral angiography.
MATERIALS AND METHODS: A total of 2,899 consecutive cerebral digital subtraction angiograms obtained with nonionic contrast material were prospectively evaluated. Neurologic complications were categorized as transient (<24 hours), reversible (24 hours to 7 days), and permanent (>7 days). The neurologic complication rate was correlated with patient age, type of indication for catheter angiography, medical history, fluoroscopic time, number and size of catheters, type and number of vessels injected, operator experience, and the quartile in which the study was performed. The correlations were statistically analyzed with Fisher exact tests and a multiple logistic regression model.
RESULTS: There were 39 (1.3%) neurologic complications in 2,899 procedures; 20 were transient (0.7%), five (0.2%) were reversible, and 14 (0.5%) were permanent. Neurologic complications were significantly more common in patients 55 years of age or older (25 of 1,361; 1.8%) (P =.035), in patients with cardiovascular disease (CVD) (20 of 862; 2.3%) (P =.004), and when fluoroscopic times were 10 minutes or longer (24 of 1,238; 1.9%) (P =.022). The neurologic complication rate was higher in procedures performed by fellows alone (24 of 1,878; 1.3%) compared with that when staff alone performed the procedures (three of 598; 0.5%), but the difference was not significant (P =.172). Neurologic complications were lower in the fourth quartile of the study (six of 171; 0.9%) compared with the first quartile (16 of 776; 2.1%), which was likely due to fewer patients being examined for carotid stenosis or ischemic stroke and fewer patients with CVD (P =.085).
CONCLUSION: Age-related vascular disease accounted for the failure to lower the neurologic complication rate of cerebral angiography despite technical advances. Copyright RSNA, 2003

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Mesh:

Year:  2003        PMID: 12637677     DOI: 10.1148/radiol.2272012071

Source DB:  PubMed          Journal:  Radiology        ISSN: 0033-8419            Impact factor:   11.105


  222 in total

1.  Use of CT angiography in comparison with other imaging techniques for the determination of embolus and remnant size in experimental aneurysms embolized with hydrogel filaments.

Authors:  M Killer; M R McCoy; M C Vestal; L Weitgasser; G M Cruise
Journal:  AJNR Am J Neuroradiol       Date:  2011-04-21       Impact factor: 3.825

2.  Quality improvement guidelines for the performance of cervical carotid angioplasty and stent placement.

Authors:  John D Barr; John J Connors; David Sacks; Joan C Wojak; Gary J Becker; John F Cardella; Bohdan Chopko; Jacques E Dion; Allan J Fox; Randall T Higashida; Robert W Hurst; Curtis A Lewis; Terence A S Matalon; Gary M Nesbit; J Arliss Pollock; Eric J Russell; David J Seidenwurm; Robert C Wallace
Journal:  AJNR Am J Neuroradiol       Date:  2003 Nov-Dec       Impact factor: 3.825

3.  Small vessel stents for intracranial angioplasty: in vitro evaluation of in-stent stenoses using CT angiography.

Authors:  M Trossbach; M Hartmann; C Braun; K Sartor; S Hähnel
Journal:  Neuroradiology       Date:  2004-05-01       Impact factor: 2.804

Review 4.  Penetrating injuries of the neck and the increasing role of CTA.

Authors:  Felipe Múnera; Jorge A Soto; Diego Nunez
Journal:  Emerg Radiol       Date:  2004-05-27

5.  Immediate evaluation of angioplasty and stenting results in supra-aortic arteries by use of a Doppler-tipped guidewire.

Authors:  Nina Ghosh; Donatella Tampieri; Denis Melancon
Journal:  AJNR Am J Neuroradiol       Date:  2004-08       Impact factor: 3.825

6.  [The significance of MR angiography for the diagnosis of carotid stenoses].

Authors:  H J Michaely; K A Herrmann; H Kramer; G Laub; M F Reiser; S O Schoenberg
Journal:  Radiologe       Date:  2004-10       Impact factor: 0.635

7.  Detection of residual brain arteriovenous malformations after radiosurgery: diagnostic accuracy of contrast-enhanced four-dimensional MR angiography at 3.0 T.

Authors:  H K Lim; C G Choi; S M Kim; J L Kim; D H Lee; S J Kim; D C Suh
Journal:  Br J Radiol       Date:  2012-01-31       Impact factor: 3.039

8.  Optimized intravenous Flat Detector CT for non-invasive visualization of intracranial stents: first results.

Authors:  Tobias Struffert; Stephan Kloska; Tobias Engelhorn; Yu Deuerling-Zheng; Sabine Ott; Marc Doelken; Marc Saake; Martin Köhrmann; Arnd Doerfler
Journal:  Eur Radiol       Date:  2010-08-14       Impact factor: 5.315

9.  Angiographic CT after intravenous contrast agent application: A noninvasive follow-up tool after intracranial angioplasty and stenting.

Authors:  M-N Psychogios; P Schramm; J-H Buhk; A Xyda; K Gröschel; K Jung; M Knauth
Journal:  AJNR Am J Neuroradiol       Date:  2010-07-15       Impact factor: 3.825

10.  Silent microemboli related to diagnostic cerebral angiography: a matter of operator's experience and patient's disease.

Authors:  T Krings; K Willmes; R Becker; I G Meister; F J Hans; M H T Reinges; M Mull; A Thron
Journal:  Neuroradiology       Date:  2006-04-04       Impact factor: 2.804

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