Cerebral angiographic risk in mild cerebrovascular disease.

Abstract

We review the eight prospective and seven retrospective studies from which it is possible to derive the complication rate of conventional cerebral angiography for patients with mild ischemic cerebrovascular disease who are potential candidates for carotid endarterectomy. Three studies of intravenous and one of intra-arterial digital subtraction angiography are also examined. An overview of the results suggests that the risk of a neurological complication (TIA or stroke) is about 4% and that a permanent neurological deficit (disabling stroke) occurs in about 1%. The mortality rate is very low (<0.1%). Systemic complications are not infrequent, particularly with intravenous digital subtraction angiography. The complication rate of cerebral angiography must be considered when evaluating the risks of carotid endarterectomy in patients with ischemic cerebrovascular disease. (Stroke 1990;21:209-222)

Risk Factors of Ischemic Lesions Related to Cerebral Angiography and Neuro-interventional Procedures

“…14) Additionally, a history of stroke and transient ischemic attack were more highly correlated with neurological complication after angiogra- Risk Factors of Ischemic Lesions in Angiography phy. 10,12) In our study, 72 (29.1%) of 247 cerebral angiography procedures resulted in HIL on DWI. Age, past history of cerebral infarction, and previous anti-platelet therapy were significantly correlated with HIL on DWI.…”

Atherosclerosis in rheumatoid arthtritis: the role of high-resolution B mode ultrasound in the measurement of the arterial intima-media thickness

“…La sua validità a questo proposito è sostenuta da: a) studi istologici, che dimostrano una stretta correlazione tra aterosclerosi carotidea e coronarica (38, 48); b) elevata correlazione osservata fra le misurazioni ultrasonografiche in vivo dello spessore parietale carotideo e quelle ottenute direttamente ed ecograficamente su campioni istologici di arterie carotidi comuni umane (15); c) correlazione significativa fra l'IMT carotideo ed i fattori di rischio cardio-vascolari (22,49). Fra le diverse tecniche di imaging, quali l'angiografia digitale a sottrazione di immagini (50,51), la tomografia computerizzata multi-detettore (50, 52-55) e l'angio-risonanza magnetica (56-59), l'ecografia bidimensionale ad alta risoluzione spaziale associata a color-Doppler viene da lungo tempo considerata la metodica di prima scelta nella diagnostica vascolare non invasiva, con particolare riferimento all'esplorazione del circolo carotideo extra-cranico (42,50,53,60,61). Essa fornisce dettagliate informazioni sulla localizzazione e sul grado di stenosi, nonché sulla composizione della placca, sulle condizioni "strutturali" della parete vasale, su eventuali evoluzioni della placca, come ulcerazione ed emorragia (50,60,61) e sulla dinamica del flusso prossimalmente e distalmente alla stenosi, consentendo, tra l'altro, di estrapolare informazioni sulla compromissione del flusso diastolico distale e quindi sul danno aterosclerotico del circolo intracranico.…”

2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease: Executive summary

“…The most feared complication is stroke, the incidence of which is <1% when the procedure is performed by experienced physicians. [118][119][120][121][122][123][124][125] Angiography may be the preferred method for evaluation when obesity, renal dysfunction, or indwelling ferromagnetic material renders CTA or MRA technically inadequate or impossible and is appropriate when noninvasive imaging produces conflicting results. In practice, however, catheter-based angiography is unnecessary for diagnostic evaluation of most patients with ECVD and is used increasingly as a therapeutic revascularization maneuver in conjunction with CAS.…”