Indications for angiography in the preoperative evaluation of patients with prolactin-secreting pituitary adenomas.

The preoperative angiograms of 100 patients subsequently undergoing transsphenoidal exploration for prolactin-secreting pituitary adenomas were reviewed in order to assess both the risk of this study and its yield of useful diagnostic information. In these patients with documented hyperprolactinemia, no vascular anomalies contraindicating a transsphenoidal approach were detected. Tumor blush was evident only in large tumors. The appearance of lateral displacement of the carotid siphon in basilar views was not a reliable predictor of lateral extension. When hyperprolactinemia can be documented, the author's current practice is to reserve angiography for patients who have gross sellar expansion or suprasellar extension, or for those who have had prior radiotherapy.