Complications of diagnostic cerebral angiography: evaluation of 19,826 consecutive patients.
OBJECTIVE
To retrospectively evaluate the complications of diagnostic cerebral catheter angiography in 19,826 consecutive patients.


METHODS
This HIPAA-compliant study had institutional review board approval, with waiver of informed consent. Demographic, procedural, and complication data in 19 826 consecutive patients undergoing diagnostic cerebral angiography at one institution from 1981 through 2003 were retrospectively reviewed. Neurologic, systemic, and local complications were recorded on the basis of clinical follow-up results after each angiographic examination. Events that occurred within 24 hours of angiography were considered to be complications of the procedure. Multivariable analysis was employed to identify patient and procedural factors significantly associated with neurologic complications.


RESULTS
Neurologic complications occurred in 522 examinations (2.63%), and 27 of these (0.14%) were strokes with permanent disability. Twelve deaths occurred (0.06%). Access-site hematoma was the most common complication overall (4.2%). Factors independently associated with an increased risk of neurologic complication included the indication of atherosclerotic cerebrovascular disease (odds ratio [OR], 2.494), the indication of subarachnoid hemorrhage (OR, 2.523), and the comorbidity of frequent transient ischemic attack (OR, 1.674). Factors independently associated with a decreased risk of neurologic complication were increasing chronologic year in which the procedure was performed (OR, 0.659 per 5-year interval) and involvement of a trainee in the procedure (OR, 0.710).


CONCLUSIONS
In this review, diagnostic catheter cerebral angiography was found to have relatively low complication rates.
Kaufmann
Timothy J
TJ
Department of Radiology, Mayo Clinic, Mayo E2, 200 1st St SW, Rochester, MN 55905, USA. Kaufmann.timothy@mayo.edu
Huston
John
J
Mandrekar
Jay N
JN
Schleck
Cathy D
CD
Thielen
Kent R
KR
Kallmes
David F
DF
D001927:Brain Diseases / Q000401:mortality*; D002533:Cerebral Angiography / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D009422:Nervous System Diseases / Q000401:mortality*; D015995:Prevalence; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate