Cerebral Angiography In Children Research Articles

Safety of pediatric cerebral angiography.

Catheter-based cerebral angiography is commonly used for neurovascular diagnosis in children. In this work, the authors aimed to quantify the complication rate of cerebral angiography in children, characterize these complications, and identify risk factors for complications. Relevant clinical data were retrospectively obtained for 587 consecutive cerebral angiography procedures performed in 390 children from March 2002 to March 2020. Complications were categorized as neurological or nonneurological, and severity was graded using a standard schema. Incidences of complications were reported as point estimates. Associations between risk factors and complications were characterized in univariate analysis using the two-tailed Fisher exact test and in multivariate analysis using multiple logistic regression with bidirectional elimination based on the Akaike information criterion. In both univariate and multivariate analyses, statistical significance was corrected for multiple comparisons using the Benjamini-Hochberg method. Complications occurred in 6.5% of procedures, including neurological complications in 1.9% and nonneurological complications in 4.8%. Permanent deficits occurred in only 0.2% of cases. Overall, 0.5% of procedures resulted in major complications, while 6.0% resulted in minor complications. Female sex and a history of hypertension or ischemic stroke were associated with an increased risk of complications, while femoral artery access was associated with a decreased risk of complications. Pediatric cerebral angiography was shown to have a low rate of major or permanent complications. Children who were female and those with a history of hypertension or ischemic stroke were shown to be at higher risk of complications, while the use of femoral access carried a lower risk of complications.

Transient flow response after femoral artery catheterization for diagnostic neuroangiography in infants and children: Doppler US assessment of the ipsilateral femoral artery.

Hemodynamic changes in the distal arteries during transfemoral catheterization in children have not been documented. To evaluate arterial flow changes of the lower extremities ipsilateral to the puncture site using Doppler US during transfemoral cerebral angiography in children. Twenty-seven children who underwent transfemoral cerebral angiography at our institution between April 2013 and August 2013 compose our study population. Doppler US was performed to evaluate diameters and peak systolic velocities of the common femoral artery and superficial femoral artery before and after femoral sheath insertion. Children were classified into three groups based on the spectral waveform changes of the superficial femoral artery after femoral sheath insertion. Thereafter, one-way ANOVA followed by the Bonferroni post-hoc comparisons test were performed to compare values among the groups. Mean common femoral artery and superficial femoral artery baseline diameters were 4.10 mm and 3.32 mm, and mean baseline peak systolic velocities were 218.26 and 166.51 cm/s, respectively. Fourteen of 27 children showed persistent triphasic flow in the superficial femoral artery (group 1); 7 children showed altered flow of biphasic (n = 3) or monophasic (n = 4) waveforms (group 2); and 6 children showed pulsus tardus et parvus pattern (group 3) after femoral sheath insertion. Mean baseline diameter of the common femoral artery and mean subtracted value between common femoral artery and femoral sheath size were significantly smaller in group 3 than the other groups. Size discrepancy between common femoral artery and femoral sheath was <1 mm in all cases of group 3. Superficial femoral artery diameter and peak systolic velocity significantly decreased after femoral sheath insertion in group 3 compared to groups 1 and 2. A significant skin temperature drop after sheath insertion in the ipsilateral lower extremity was noted in group 3 (-1.83°C), compared to groups 1 and 2 (+0.42 and -0.86°C, respectively). Changes in the spectral waveforms of superficial femoral arteries frequently occur in children during transfemoral cerebral angiography (13/27, 48%). Significant arterial flow disturbance was noted on Doppler US in children with a common femoral artery <1 mm larger than the femoral sheath diameter.

Complications of cerebral angiography in children younger than 3 years of age

The therapeutic potential for cerebral angiography (CA) in young children is expanding. However, its use in this patient population is limited by presumed higher complication rates among children. Therefore, to improve the accuracy of counseling of the parents/guardians of these patients and to identify modifiable risk factors, the authors evaluated complications after CA in young children. The authors reviewed data for 309 consecutive cerebral angiograms obtained in 87 children younger than 36 months of age from 2004 to 2010 at a single institution. They analyzed demographics, diagnosis, angiographic findings, and complications. The patient population comprised 40 boys and 47 girls; mean age was 14.36 months (range 1-36 months) and mean weight was 10.8 kg (range 3.7-21.0 kg). For 292 of the 309 procedures, intraarterial chemotherapy was administered; the remaining 17 procedures were for vascular malformations, stroke, tumor embolization, and intracranial hemorrhage. The rate of neurological complications was 0.0%. The rate of nonneurological complications was 2.9%: 7 cases of contrast allergy or bronchospasm, 1 groin hematoma (body weight 7 kg), and 1 transient femoral artery occlusion (body weight 10.8 kg). The rate of radiographic complications was 1.3%: 1 case of transient asymptomatic intraarterial dissection and 3 cases of asymptomatic vasospasm. Postprocedural MRI was performed for 33.3% of patients with no evidence of ischemia. There were no delayed complications. Mean follow-up time was 16.6 months. No association was found between complications and age, duration of anesthesia, number of vessels catheterized, size of the sheath, or diagnostic versus interventional procedures. Despite a trend toward a higher rate of complications for patients who weighed less than 15 kg, this finding was not significant (p = 0.35). The rate of complications for CA in young children is comparable to rates reported for older children and lower than rates reported for adults. When appropriately indicated, CA should not be omitted from the therapeutic strategy of children younger than 36 months of age.

Safety of Cerebral Digital Subtraction Angiography in Children

Catheter-based cerebral angiography remains an important diagnostic tool in the pediatric population, particularly considering the currently growing interest in diagnosing and treating cerebrovascular disorders in children. There are no recent estimates of the complication rate associated with modern diagnostic digital subtraction angiography (DSA) in the pediatric population. The purpose of this study was to estimate the rate of complications occurring during cerebral angiography in children. Data from 241 consecutive pediatric cerebral angiograms performed at a single institution were entered into an institutional review board-approved database. Information on patient demographics, DSA indication, neurovascular diagnosis, and intra procedural and postprocedural complications was collected. Our population included 115 boys and 90 girls, with age ranging from 1 week to 18 years (mean+/-SD, 12+/-5 years). All angiograms were technically successful. No intraprocedural complication was noted; in particular, there was no occurrence of iatrogenic vessel injury (dissection) and no transient or permanent neurological deficit secondary to a thromboembolic event. One child with a complex dural arteriovenous fistula experienced a fatal intracranial rehemorrhage secondary to a posterior fossa varix rupture 3 hours after completion of an uneventful diagnostic angiogram. The rates of intraprocedural and postprocedural complications were therefore 0.0% (95% CI, 0.0% to 1.4%) and 0.4% (95% CI, 0.012% to 2.29%), respectively. The rate of immediate complications occurring during diagnostic cerebral angiography in children is very low. No intraprocedural complication was documented in the reported series. DSA performed by experienced angiographers is a safe procedure that can provide critical diagnostic information.

Conventional cerebral angiography in children with ischemic stroke

A retrospective review of conventional cerebral angiograms of 46 children with ischemic stroke was undertaken. Comparison was made with findings on magnetic resonance imaging and magnetic resonance angiography where available. Thirty-six children (78%) underwent magnetic resonance angiography in addition to conventional cerebral angiography. Seven patients had normal cerebral angiograms. Magnetic resonance angiography was diagnostic in 25 of 28 patients with large vessel occlusion, stenosis, or moyamoya syndrome. Conventional angiography was abnormal in four of nine patients with a normal magnetic resonance angiography. All patients with normal conventional angiograms also had normal magnetic resonance angiograms. Conventional angiography, either diagnostic or yielding further information, altered management in five patients with arterial dissection, one patient with large vessel occlusion, one patient with large vessel stenosis, and four patients with arteritis. On the basis of this experience, a clinical algorithm for the use of conventional cerebral angiography in the investigation of ischemic stroke in children is proposed.

Diagnosis of posterior fossa tumors with angiography in children.

The differential diagnosis of posterior fossa tumors with cerebral angiography in children is presented with diagrams and illustrations. The literature is reviewed and the angiographic landmarks are discussed. The advantage of this form of examination over other methods of contrast studies is emphasized. It is concluded that the detailed analysis of the angiographic findings in posterior fossa tumors in children can be of localizing and of diagnostic value in the majority of cases, and surgery can then be, performed without additional contrast studies.

Cerebral angiography in children and adults with mental retardation. II. Mentally retarded group.

Cerebral angiography in children and adults with mental retardation. II. Mentally retarded group.

Cerebral angiography in children and adults with mental retardation. I. Control series.

Cerebral angiography in children and adults with mental retardation. I. Control series.

Percutaneous catheterization of the femoral artery in infants, using a scalp vein needle.

HomeRadiologyVol. 102, No. 2 PreviousNext Pediatric RadiologyPercutaneous Catheterization of the Femoral Artery in Infants, Using a Scalp Vein NeedleFaustino C. Guinto, Jr., William B. RadcliffeFaustino C. Guinto, Jr., William B. RadcliffeFaustino C. Guinto, Jr.William B. RadcliffePublished Online:Feb 1 1972https://doi.org/10.1148/102.2.408MoreSectionsPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In AbstractThe authors describe a simple method of percutaneous femoral artery catheterization for cerebral angiography in children, using a 19 gauge disposable scalp vein needle.Article HistoryAccepted: Nov 1971Published in print: Feb 1972 FiguresReferencesRelatedDetailsCited ByDisposable equipment for percutaneous angiography in infancy and childhoodK.Bergstr�m, H.Jorulf1973 | Pediatric Radiology, Vol. 1, No. 4Recommended Articles RSNA Education Exhibits RSNA Case Collection Vol. 102, No. 2 Metrics Altmetric Score PDF download

Catheter cerebral angiography in children: Analysis of 67 examinations

The technique of transfemoral catheter cerebral angiography in children has been described on the basis of 67 examinations performed on 62 patients of paediatric age group. Relative ease and safety of this procedure has been emphasized as well as other advantages over alternative methods. This technique is the best and safest method for obtaining constantly reliable cerebral angiograms in children.

Technique of cerebral angiography in children.

TECHNIQUE OF CEREBRAL ANGIOGRAPHY IN CHILDRENR. S. BOULOS, M.D., JOHN GILROY, M.D., F.R.C.P.(C) and JOHN STIRLING MEYER, M.D.Audio Available | Share

97. Complications of cerebral angiography in children

97. Complications of cerebral angiography in children

NARCOSIS FOR NEURORADIOLOGIC PROCEDURES IN CHILDREN.

Since pneumoencephalography was first performed in infants by Dandy1in 1918 and cerebral angiography in an 11-year-old girl by Moniz2in 1928 many clinical and technical aspects of these procedures in children have been frequently discussed, but the method of narcosis for these studies has received little critical attention. In adults sedation is usually preferred, but for infants and children general anesthesia is advocated to secure proper positioning and lack of motion during filming. In recent years, however, the wide use of heavy sedation for cardiac catheterization has encouraged its trial in the performance of neuroradiologic procedures in children. Based on the experience of a large pediatric neurology service, this report seeks to assess in a retrospective study the comparative value of general anesthesia and heavy sedation as methods of narcosis for pneumoencephalography and cerebral angiography in children. Material The studies on which this report is based were

Observations about retrograde brachial cerebral angiography in children (analysis of 100 aortographies and 28 cerebral angiographies via the brachial artery).

The results of 100 aortographies and 28 cerebral angiographies performed by contercurrent manual injection through the brachial artery in children under 5 years of age are described. The technique, complications and incidence of filling of the carotid and vertebral arteries are discussed. The effect of malformations of the major thoracic vessels upon filling of the cerebral vessels is also analysed. The following conclusions follow from this study:

CLINICAL ASPECTS OF CEREBRAL ANGIOGRAPHY IN CHILDREN

A series of 90 children subjected to cerebral angiography is reviewed. One hundred thirty-one cerebral angiograms were performed of which 117 were by the percutaneous method. All but 2 were done under general anesthesia. Cerebral angiography was of definite diagnostic value in 43.5 per cent of the patients. No fatalities were encountered in this series. Morbidity and complications were present in 35 per cent of the procedures but all were mild and transient. Complications believed to be due specifically to angiography were present in 20 per cent. It is felt that the morbidity and complications are affected in some way by general anesthesia and premedication. Morbidity in cerebral angiography in children is lower than in pneumoencephalography performed under the same conditions in a comparable group of children. Cerebral angiography is a useful and relatively harmless procedure in children when the proper precautions are taken and the indications are definite. The percutaneous technique is suitable for children of all ages.

Cerebral angiography in children; an anatomoclinical evaluation.

Cerebral angiography in children; an anatomoclinical evaluation.