Complications Of Cerebral Angiography Research Articles

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.

Cerebral Angiography Induced Prolonged Focal Seizure and Hemiparesis during Carotid Artery Balloon Test Occlusion

The frequency of neurologic complications of cerebral angiography is 0.3%-2.3%, and the frequency of the persistent neurologic deficits that remain over 7-10 days is 0.4%-0.5%. On the other hand, all neurologic complications of balloon test occlusion (BTO) have been reported in 0%-8.3% and especially in 1.6%-1.7% of symptomatic neurologic complications. There are a few reports concerning a seizure related to cerebral angiography and BTO. We report a case of prolonged seizures and left hemiparesis during and after BTO of the right internal carotid artery. The patient showed repeated focal seizures and prolonged left hemiparesis lasting for approximately 2 months. Computed tomography and magnetic resonance imaging demonstrated no abnormal findings. Suspected mechanisms of seizure were a cerebral blood flow change induced by BTO and neurotoxicity of accumulated contrast medium. A combination of prolonged focal seizures and subsequent hemiparesis is a rare complication of BTO, which should be taken into consideration during BTO.

Complications of cerebral angiography: a prospective analysis of 2,924 consecutive procedures

Cerebral angiography is an invasive procedure associated with a small, but definite risk of neurological morbidity. In this study we sought to establish the nature and rate of complications at our institution among a large prospective cohort of consecutive patients. Also, the data were analysed in an attempt to identify risk factors for complications associated with catheter angiography. Data were prospectively collected for a consecutive cohort of patients undergoing diagnostic cerebral angiography between January 2001 and May 2006. A total of 2,924 diagnostic cerebral angiography procedures were performed during this period. The following data were recorded for each procedure: date of procedure, patient age and sex, clinical indication, referring specialty, referral status (routine/emergency), operator, angiographic findings, and the nature of any clinical complication or asymptomatic adverse event (arterial dissection). Clinical complications occurred in 23 (0.79%) of the angiographic procedures: 12 (0.41%) significant puncture-site haematomas, 10 (0.34%) transient neurological events, and 1 nonfatal reaction to contrast agent. There were no permanent neurological complications. Asymptomatic technical complications occurred in 13 (0.44%) of the angiographic procedures: 3 groin dissections and 10 dissections of the cervical vessels. No patient with a neck dissection suffered an immediate or delayed stroke. Emergency procedures (P = 0.0004) and angiography procedures performed for intracerebral haemorrhage (P = 0.02) and subarachnoid haemorrhage (P = 0.04) were associated with an increased risk of complications. Neurological complications following cerebral angiography are rare (0.34%), but must be minimized by careful case selection and the prudent use of alternative noninvasive angiographic techniques, particularly in the acute setting. The low complication rate in this series was largely due to the favourable case mix.

Neurologic Complications of Cerebral Angiography

Primary care physicians who evaluate patients for carotid artery disease should remember that a potential downstream consequence of a positive result

Complications of cerebral angiography in patients with symptomatic carotid territory ischaemia screened by carotid ultrasound.

After nearly 40 years, carotid endarterectomy has been shown to be of benefit to patients with symptomatic carotid territory ischaemia and greater than 70% stenosis of the relevant internal carotid artery. Cerebral angiography is performed before surgery and is not without risk. These risks must be added to those of surgery before recommending the procedure to patients. The study evaluated the local, systemic and neurological complications following digital subtraction angiography with selective catheterisation of the carotid arteries in 200 patients presenting to a cerebrovascular clinic for assessment of cerebral ischaemia. All patients had carotid ultrasound screening before angiography to screen out those with normal arteries or mild disease (less than 30% stenosis of symptomatic internal carotid artery). Complications occurred in 28 patients. There were six (3%) local, two (1%) systemic and 20 (10%) neurological complications. Seventeen neurological complications occurred within 24 hours and there were three late complications (24-72 hours). Neurological complications occurred more frequently when angiography was performed by a trainee rather than a consultant neuroradiologist (p < 0.01). The neurological complications were transient (resolved within 24 hours) in 10/200 (5%), reversible (resolved within seven days) in two (1%) and permanent in 8/200 (4%). Two patients died after a stroke and two other patients suffered a disabling stroke. At 24 hours post angiography the permanent (persisting beyond seven days) neurological complication rate was 2.5%. The incidence of total neurological complications and post angiographic strokes was higher in patients with greater than 90% stenosis of the symptomatic internal carotid artery (p < 0.001). The increased use of non-invasive Doppler duplex screening will reduced the absolute number of patients put at risk of angiography, yet the rate of post angiographic complications is likely to increase as patients with severe stenosis of the symptomatic internal carotid artery are probably most at risk of complications and have most to gain from carotid endarterectomy.

Complications of cerebral angiography in a teaching hospital.

ABSTRACTA retrospective survey of the complications arising in 314 patients who underwent cerebral angiography showed an incidence of 0.3% of permanent neurologic deficit for diagnostic studies. Patients at risk appear to be those with subarachnoid haemorrhage and arterial spasm and older patients with “crescendo” transient ischaemic attacks.

Complications of cerebral angiography: prospective assessment of risk.

A prospective study of 1,517 consecutive cerebral angiographic examinations is reported. The incidence of all complications was 8.5%, and the incidence of all neurologic complications was 2.6%. The overall incidence of permanent neurologic deficit was 0.33%. The incidence of permanent neurologic deficit in patients referred for evaluation of symptomatic cerebrovascular disease was 0.63%. Older age, increased serum creatinine concentration, and the use of more than one catheter all were significantly associated with serious neurologic complications. Although patients with a recent stroke or frequent transient ischemic attacks had a higher incidence of serious neurologic complications, this increase was not statistically significant for this sample.

Complications of cerebral angiography and pneumography.

There were incidences of 0.7% severe and 5.5% mild complications in 1,971 direct puncture carotid angiograms done over a 5-year period. In 1,035 retrograde branchial angiograms, there was a 0.6% incidence of severe, and a 4.7% incidence of mild, complications. Complications tended to increase with increasing age of the patient. Brachial angiography is virtually free of life-threatening complications, and the incidence of neurological sequelae was markedly less than that shown by a comparable analysis of catheter angiography. Of patients undergoing 1,542 fractional pneumoencephalograms, 2 had severe complications.

Complications of cerebral angiography.

All types of complications, both minor and major, are tabulated and analyzed in 5531 consecutive cerebral angiographies performed on 3730 patients during a period of 5 years.

Complications of cerebral angiography: preliminary report of 432 examinations.

Complications of cerebral angiography: preliminary report of 432 examinations.

A national survey of radiological complications: Interim report

Two hundred and sixty five radiologists co-operated in a national survey of radiological complications. The case reports have been analysed and are presented together with a review of the relevant literature. One third of the cases of sudden death in the X-ray department occur when a doctor is unlikely to be present—usually during chest X-rays—and radiographic staff should therefore be conversant with the immediate treatment of cardiac arrest. Attention is drawn to the hazard of perforation associated with the use of self-retaining catheters for barium enema examinations. The clinical features of contrast media reactions are described and the possible mechanisms of some of these reactions are discussed. Biligrafin should preferably not be administered immediately following oral cholecystography. In cardiovascular investigations, vascular disease may be widespread and coronary thrombosis may follow arteriography. Several deaths followed cardioangiography, and other complications of importance were ventricular fibrillation and pericardial tamponade. Two cases of paraplegia followed translumbar aortography. The main complications of Seldinger catheterisation are arterial occlusion and dissection; guide wire fracture may also occur, In hypertensive patients, excessive bleeding may give rise to complications. Axillary catheterisation may cause peripheral nerve injury. In thoracic aortography, the main complications are due to neurological damage. Complications of cerebral angiography may be related to arterial trauma, and hypotension is also hazardous. Other complications covered in the survey are those occurring during myelography, encephalography, pneumography, bronchography, lymphangiography, salpingography and sialography. There is a brief discussion on electrical hazards.

Complications of cerebral angiography.

SUMMARYThe total neurological complication rate in 783 consecutive carotid angiograms was 2.3% (2.7 % per patient). The permanent complication rate, including death, was 1.5% (1–8% per patient).With one exception, the patients in the permanent neurological complication group were over the age of 50.Of the patients experiencing neurological complications, 55.5% had received an intramural injection of contrast medium into the common carotid artery.The use of polaroid film to check the position of the needle is advocated to minimize intramural injection of contrast medium.Toxic side effects of the contrast medium was a less common cause for complications, but was considered potentially harmful in those patients with occlusive cerebro‐vascular disease.General anaesthesia should be kept to a minimum, particularly in patients with subarachnoid haemorrhage, as the complication rate is two to three times higher than when angiography is carried out under local anaesthetic.

97. Complications of cerebral angiography in children

97. Complications of cerebral angiography in children

S20. Complications of Cerebral Angiography

S20. Complications of Cerebral Angiography

Complications of cerebral angiography in 2,000 consecutive cases.

Complications of cerebral angiography in 2,000 consecutive cases.

SPONTANEOUS STROKES IN THE YOUNG

Article1 November 1958SPONTANEOUS STROKES IN THE YOUNGHAROLD STEVENS, Ph.D., M.D., F.A.C.P.HAROLD STEVENS, Ph.D., M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-49-5-1022 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe spontaneous occurrence of cerebrovascular accidents in normotensive healthy individuals is contrary to the conventional notion that arteriosclerotic and occlusive vascular disease of the brain is a phenomenon of old age. Yet strokes in the young are not rare. Thirty-two such cases in young adults and two in children have been encountered by the author in private neurologic practice in the last seven years.Acute hemiplegia and other focal neurologic manifestations characterize this group. The ages range from five and one-half years to 45 years, the arbitrary cut-off point of this selection. No cases are included that had traumatic, infectious,...Bibliography1. Stevens H: Cerebral venous thromboses in childhood, in press. Google Scholar2. Hyland H: Intracranial venous thromboses in the puerperium, J. A. M. A. 142: 707, 1950. CrossrefMedlineGoogle Scholar3. Stevens H: Puerperal hemiplegia, Neurology 4: 723, 1954. CrossrefMedlineGoogle Scholar4. StevensAmmerman HH: Intracranial venous thrombosis in early pregnancy, Am. J. Obst. and Gynec., in press. Google Scholar5. Stevens H: Carotid artery thrombosis in childhood, Pediatrics, in press. Google Scholar6. Fisher M: Occlusion of the carotid arteries, Arch. Neurol. and Psychiat. 72: 187, 1954. CrossrefGoogle Scholar7. KaplanWalker AA: Complications of cerebral angiography, Neurology 4: 643, 1954. CrossrefMedlineGoogle Scholar8. RowbothamHayKirby GRA: Technique and dangers of cerebral angiography, J. Neurosurg. 10: 602, 1953. CrossrefMedlineGoogle Scholar9. 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Author, Article, and Disclosure InformationAffiliations: Washington, D. C.*Presented at the Thirty-ninth Annual Session of The American College of Physicians, Atlantic City, New Jersey, April 28, 1958.From the Department of Neurology, George Washington University School of Medicine, Washington, D. C.Requests for reprints should be addressed to Harold Stevens, M.D., Professor of Neurology, George Washington University School of Medicine, Washington, D. C. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byPredictors of outcome of stroke in infants and children based on clinical data and radiologic correlatesIschemic cerebrovascular disease in the young. Two common causes in India.CEREBRAL VASCULAR DISEASE IN PREGNANCY 2-OCCLUSIONTHE LITTLE STROKEIntracranial venous thrombosis in early pregnancyInfluence of Some Vasoactive Drugs on Fibrinolytic ActivityTreatment of a Stroke 1 November 1958Volume 49, Issue 5Page: 1022-1034KeywordsAnticoagulantsLesionsNeurologyPathogensStrokeSyphilisThrombosisVascular diseasesVascular medicineYoung adults ePublished: 1 December 2008 Issue Published: 1 November 1958 PDF downloadLoading ...

Complications of cerebral angiography.

Complications of cerebral angiography.