title: Audit of diagnostic and interventional craniocervical catheter angiographic procedures at the Singapore General Hospital.
abstract: BACKGROUND
  Catheter angiography is an established imaging modality of evaluating cerebral and head and neck vascular diseases. It is, however, an invasive procedure with a small risk of complications. The aim of our study was to evaluate the prevalence of peri-procedural complications in a local hospital setting.
  
  
  METHODS
  A total of 88 patients underwent diagnostic and interventional craniocervical procedures over 6 months in our department. The casenotes of 83 patients were retrospectively reviewed for complications arising from a total of 99 procedures carried out.
  
  
  RESULTS
  A new focal neurological deficit developed in 3 different patients after a procedure, giving a prevalence of 3.0%. All these occurred in diagnostic procedures and were permanent deficits with correlative computed tomography (CT) or magnetic resonance (MR) imaging findings of acute cerebral infarction. All these occurred in high-risk patients who had severe underlying cerebrocarotid vascular compromise. There was 1 case of contrast medium-induced nephropathy (1.0%), occurring in a patient with pre-existing renal impairment. Local complications included 1 case of iatrogenic external iliac artery dissection (1.0%) and 5 cases (5.1%) of small and uncomplicated puncture site groin haematomas.
  
  
  CONCLUSIONS
  The most significant complication associated with a craniocervical angiographic procedure was the development of post-procedural stroke in patients with significant preexisting cerebrocarotid vascular compromise. In the absence of this risk factor, craniocervical catheter angiography is a relatively safe procedure.
authors.affiliation: Department of Diagnostic Radiology, Singapore General Hospital, Singapore.
authors.forename: A S C
authors.initials: AS
authors.lastname: Low
authors.forename: W E H
authors.initials: WE
authors.lastname: Lim
authors.forename: L L
authors.initials: LL
authors.lastname: Chan
authors.forename: H M
authors.initials: HM
authors.lastname: Tan
authors.forename: K P
authors.initials: KP
authors.lastname: Tan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000295:instrumentation / Q000379:methods; D002544:Cerebral Infarction / Q000000981:diagnostic imaging* / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods; D005260:Female; D006769:Hospitals, General / Q000592:standards; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D011336:Probability; D011379:Prognosis; D015641:Radiography, Interventional / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D015607:Stents; D016896:Treatment Outcome