Complications of cerebral angiography in children younger than 3 years of age

Abstract

<jats:sec> <jats:title>Object</jats:title> <jats:p>The therapeutic potential for cerebral angiography (CA) in young children is expanding. However, its use in this patient population is limited by presumed higher complication rates among children. Therefore, to improve the accuracy of counseling of the parents/guardians of these patients and to identify modifiable risk factors, the authors evaluated complications after CA in young children.</jats:p></jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>The authors reviewed data for 309 consecutive cerebral angiograms obtained in 87 children younger than 36 months of age from 2004 to 2010 at a single institution. They analyzed demographics, diagnosis, angiographic findings, and complications.</jats:p></jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>The patient population comprised 40 boys and 47 girls; mean age was 14.36 months (range 1–36 months) and mean weight was 10.8 kg (range 3.7–21.0 kg). For 292 of the 309 procedures, intraarterial chemotherapy was administered; the remaining 17 procedures were for vascular malformations, stroke, tumor embolization, and intracranial hemorrhage. The rate of neurological complications was 0.0%. The rate of nonneurological complications was 2.9%: 7 cases of contrast allergy or bronchospasm, 1 groin hematoma (body weight 7 kg), and 1 transient femoral artery occlusion (body weight 10.8 kg). The rate of radiographic complications was 1.3%: 1 case of transient asymptomatic intraarterial dissection and 3 cases of asymptomatic vasospasm. Postprocedural MRI was performed for 33.3% of patients with no evidence of ischemia. There were no delayed complications. Mean follow-up time was 16.6 months. No association was found between complications and age, duration of anesthesia, number of vessels catheterized, size of the sheath, or diagnostic versus interventional procedures. Despite a trend toward a higher rate of complications for patients who weighed less than 15 kg, this finding was not significant (p = 0.35).</jats:p></jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>The rate of complications for CA in young children is comparable to rates reported for older children and lower than rates reported for adults. When appropriately indicated, CA should not be omitted from the therapeutic strategy of children younger than 36 months of age.</jats:p></jats:sec>

Safety of Diagnostic Cerebral and Spinal Digital Subtraction Angiography in a Developing Country: A Single-Center Experience

“…Recently, another study conducted by Ning et al [20] analyzed data from 429 consecutive diagnostic angiograms performed on children younger than 18 years of age and reported a complication rate of 0% for any neurological event and 0.7% for nonneurological events (2 intraprocedural and 1 postprocedural). Similar results were reported by Hoffman et al [22] in a study where 309 cerebral angiograms were obtained from 87 children younger than 3 years of age. The rate of neurological complications in this study was 0% and for nonneurological complications 2.9%.…”

Emergency Neurological Life Support: Intracerebral Hemorrhage

“…The diagnosis of cerebral vasospasm is particularly challenging in children given that cerebral blood flow velocity is age and gender dependent [66,67]. When clinically indicated, cerebral angiography has similar complication rates compared to those reported in adults, even in children younger than 3 years of age [68].…”

Safety of neuroangiography and embolization in children: complication analysis of 697 consecutive procedures in 394 patients

“…Wolfe et al 37 reviewed a series of 46 cerebral angiograms on 42 patients and reported no periprocedural complications. Hoffman et al 9 reviewed a series of 309 cerebral angiograms performed in 87 children < 36 months of age; 292 of the angiograms were performed for intraarterial chemotherapy. They reported a nonneurological complication rate of 2.9% and no neurological complications.…”