Complication rates of diagnostic cerebral arteriography in children.
BACKGROUND
Cerebral arteriography (CA) remains the gold standard in delineating both intra- and extracranial vascular anatomy. Most data relating to the safety of CA are drawn from studies of adult patients in whom the practicalities of the procedure, range of potential pathologies and comorbid factors are different from those in children.


OBJECTIVE
To evaluate the current local and neurological complication rates of paediatric CA in the setting of a tertiary level children's hospital in the UK.


METHODS
Data from patients who had undergone CA between January 1998 and July 2003 were reviewed. The medical, anaesthetic and nursing records, and angiography reports were reviewed for all identified patients. The following parameters were extracted and entered into a proforma: gender, age, ethnicity, diagnosis, cerebrovascular diagnosis, referral source, date of CA, number of vessels catheterized and local and neurological complications.


RESULTS
A total of 176 CA studies were undertaken in 150 patients (median age 7.3 years, range neonate to 19 years; 83 males, 67 females) during the 5.5-year study period. The majority of referrals originated from the neurology (58%) and neurosurgery services (27.8%). No neurological complications or deaths occurred. Local complications occurred in eight children (4.5%). Five children had a groin haematoma and two had bleeding at the puncture site. A single child had a reduced pedal pulse distal to the site of catheterization, but Doppler imaging was normal.


CONCLUSIONS
CA has a continuing role in the evaluation of cerebrovascular pathologies in children. Neurological complications are rare and local complications are not uncommon (around 5%), but are not usually serious.
Fung
Eva
E
Neurology Department, Great Ormond Street Hospital, Great Ormond Street, London, WC1N 3JH, UK. eva1809@hotmail.com
Ganesan
Vijeya
V
Cox
Timothy S C
TS
Chong
Wui Khean
WK
Saunders
Dawn E
DE
D000293:Adolescent; D000328:Adult; D002533:Cerebral Angiography / Q000009:adverse effects*; D002561:Cerebrovascular Disorders / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D011677:Punctures / Q000009:adverse effects*; D012189:Retrospective Studies; D006113:United Kingdom / Q000453:epidemiology