Cerebral thromboembolic complications during cerebral angiography and their risk factors in different subgroups: Analysis of 2,457 procedures.

PURPOSE: Diagnostic cerebral digital subtraction angiography (DSA) is an invasive examination that involves catheterization of the major supra-aortic arterial trunks and evaluation of intracranial vessels for diagnostic purposes. Although considered the gold standard method for investigating cerebrovascular diseases, DSA carries measurable and potentially serious complication rates. This report describes the frequency of neurological and non-neurological complications of DSA performed in five hospitals in the state of São Paulo, Brazil, and analyzes them in different disease subgroups. It has a special focus on thromboembolic cerebral complications. METHODS: We retrospectively reviewed clinical records of all adult patients who underwent DSAs between January 2019 and December 2022. Demographic variables, DSA reports, CT/MRI reports, and clinical follow-up notes were reviewed. RESULTS: Twenty-four patients experienced some type of complication among 2,457 diagnostic DSAs (0.97%). Thromboembolic complications were recorded in 9 patients (0.36%), and access site hematomas larger than 5 cm were registered in six patients (0.24%). There was a statistical trend for thromboembolic complications in patients with cervical and/or intracranial atherosclerosis (p = 0.07), but age was not associated with them (p = 0.93). Patients who received heparin had lower rates of embolic complications than those who did not receive it, but there was no statistically significant difference (p = 0.17). Intravenous administration of heparin showed a trend toward significance with groin hematoma (p = 0.10). CONCLUSION: Diagnostic catheter DSAs have low complication rates.

The spectrum of symptomatic arterialized developmental venous anomalies: case reports.

Developmental venous anomaly (DVA) is an anatomical variation of the intracranial venous system, usually without clinical repercussion. In most cases, DVAs are incidentally diagnosed and should be considered as benign conditions. In rare circumstances, DVAs may become symptomatic due to mechanical or flow-related etiologies. The authors present three cases of symptomatic arterialized DVAs: a 28-year-old male with hematoma at the splenium of the corpus callosum and intraventricular hemorrhage, a 53-year-old male patient with a history of epileptic seizures starting recently, and a 25-year-old male patient, previously healthy who started with persistent headaches and hemosiderin deposition in brain parenchyma. These rare cases of arterialized DVAs are conditions that can cause symptoms or show more aggressive behavior with bleeding.

Late Diagnosed Left Coronary to the Pulmonary Artery Large Fistulae: An Interesting and Incidental Cath Lab Finding.

Coronary artery anomalies are congenital changes in their origin, course, and/or structure. Most of them are discovered as incidental findings during coronary angiographic studies or at autopsies. A coronary artery fistulae involve a communication between a coronary artery and a chamber of the heart or any segment of the systemic or pulmonary circulation. We present herein the case of a 67-year-old man with a recent history of exertional angina and dyspnea to usual daily activities whose coronary angiogram revealed an interesting and incidental coronary-pulmonary artery large fistulae.