Diagnostic cerebral angiography: the interventional neurology perspective.

ABSTRACT

BACKGROUND/OBJECTIVE: Cerebral angiography (CA) is increasingly used in clinical practice with advances in neurointerventional therapy. We present our CA experience performed by neurologists at an academic institution. METHOD: CA performed between July 2005 and March 2008 was reviewed. Major neurological outcome was defined as a new neurological deficit lasting >24 hours or worsening of pre-existing neurological deficit by 4 points on the National Institutes of Health Stroke Scale. Major non-neurological outcomes were defined as any death within 24 hours of the procedure, vascular injury requiring surgery, arteriovenous fistula, or pseudo-aneurysm formation and access site hematoma >5 cm, and/or requiring blood transfusion. RESULTS: In total 661 angiograms were performed over 30 months. CA indications were ischemic stroke in 210/661 (31.7%), hemorrhagic stroke in 321/661 (48.6%), trauma for 16/661 (2.4%), presurgical epilepsy workup 95/661 (14.3%), and other conditions 19/661 (2.9%). Mean age of the group was 49 +/- 18 years. Permanent neurological deficit occurred in .2% (1 patient) and reversible neurological deficits occurred in .2% (1/661). Major non-neurological complications occurred in .9% (6/661). All these rates were less than established guidelines. CONCLUSIONS: The safety and efficacy of CA performed by interventional neurologists is acceptable by current guidelines.