title: Current utility of diagnostic catheter cerebral angiography.
abstract: BACKGROUND
  The role of diagnostic catheter cerebral angiography has been recently thought to have diminished with the increasing use of noninvasive modalities such as computed tomography angiography and magnetic resonance angiography. Because it is invasive and costly, we sought to elucidate the clinical utility of catheter angiography by evaluating the indications, incidence of new and clinically meaningful findings, and its utility compared with noninvasive studies.
  
  
  METHODS
  We performed an observational cross-sectional study of consecutive patients undergoing diagnostic cerebral angiography at an urban tertiary care center. We prospectively recorded procedural indications, the findings of previously performed noninvasive studies, the actual angiogram findings, and whether these were new. We defined a new finding as any novel and clinically meaningful piece of anatomic brain vascular information.
  
  
  RESULTS
  Of the 200 consecutive studies over 8 months, 55% were for purely diagnostic purposes, whereas the remaining were for surveillance. The most common indications were subarachnoid hemorrhage, ischemic stroke, intracerebral hemorrhage, cerebral aneurysm, and arteriovenous malformation. New findings were detected in 43% of purely diagnostic angiograms and 32% of surveillance studies. We found false-negative rates of 9.9% and false-positive rates of 11.7%. In 23.4% of cases, more precise anatomic information was found that was subjectively deemed clinically meaningful.
  
  
  CONCLUSIONS
  Our snapshot of 200 consecutive catheter cerebral angiograms shows that it is used for both primary diagnosis and surveillance in a wide variety of indications. Despite recent imaging trends, diagnostic catheter angiography provides clinically meaningful diagnostic information in enough cases to warrant continued use.
authors.affiliation: Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois; Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois.
authors.forename: Nader
authors.initials: N
authors.lastname: Sawiris
authors.affiliation: Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois; Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois.
authors.forename: Alexander
authors.initials: A
authors.lastname: Venizelos
authors.affiliation: Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois; Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois.
authors.forename: Bichun
authors.initials: B
authors.lastname: Ouyang
authors.affiliation: Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois; Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois.
authors.forename: Demetrius
authors.initials: D
authors.lastname: Lopes
authors.affiliation: Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois; Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois. Electronic address: michael_chen@rush.edu.
authors.forename: Michael
authors.initials: M
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002533:Cerebral Angiography / Q000295:instrumentation*; D002536:Cerebral Arteries / Q000000981:diagnostic imaging*; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging* / Q000628:therapy; D002641:Chicago; D003430:Cross-Sectional Studies; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D062606:Tertiary Care Centers; D014057:Tomography, X-Ray Computed; D062666:Vascular Access Devices; D055815:Young Adult
keywords: Diagnostic cerebral angiography; computed tomography angiography; diagnostic yield; magnetic resonance angiography