Ischemic lesions related to cerebral angiography: Evaluation by diffusion weighted MR imaging

Kato, Koki; Tomura, Noriaki; Takahashi, Satoshi; Sakuma, Ikuo; Watarai, Jiro

doi:10.1007/s00234-002-0889-5

Cited by 54 publications

(36 citation statements)

References 10 publications

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“…1) The results of occlusion tests of the internal carotid arteries were significantly correlated with the appearance of HIL on DWI. 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.…”

Section: Discussionmentioning

confidence: 96%

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

Sato

Nakai

Tsurushima

et al. 2013

Neurol. Med. Chir.(Tokyo)

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Embolic stroke is not a rare complication of cerebral angiography. The risk factors for incidental embolism after cerebral angiography were retrospectively examined using diffusion-weighted magnetic resonance imaging (DWI) in 180 patients who underwent 247 angiography procedures, consisting of 174 diagnostic angiography and 73 interventional procedures, and magnetic resonance imaging including DWI within 72 hours after angiography. The two neuroradiologists in our hospital detected embolism after cerebral angiography as high-intensity lesions (HIL) on DWI. The relationships between HIL on DWI and procedural factors were evaluated. DWI after cerebral angiography revealed HIL related to the procedure in 72 of 247 angiographies. In all procedures, age (p º 0.01), past history of cerebral infarction (p º 0.05), anti-platelet therapy (p º 0.05), neuro-intervention (p º 0.01), and total amount of contrast medium (odds ratio [OR] 2.125, 95% confidence interval [CI] 1.045-4.321) were significantly correlated with HIL. In diagnostic angiography, the performance of the procedure by a resident operator (OR 2.526, 95% CI 1.214-5.254) was significantly correlated with HIL. Age, past history of cerebral infarction, and previous anti-platelet therapy determined the risk of atherosclerotic changes in patients. The neuro-intervention and total amount of contrast medium used could predict the risk of time limitations for angiography. Resident operator is also a risk factor. This study demonstrates the importance of improving the risk of time limitations for angiography and the risk due to operator inexperience. Further training of residents may be needed to reduce the occurrence of embolic complications.

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Section: Discussionmentioning

confidence: 96%

“…1,2,14) The amount of contrast medium used, fluoroscopic time, and use of additional catheters were risk factors for the detection of HIL on DWI after cerebral angiography. 1) The results of occlusion tests of the internal carotid arteries were significantly correlated with the appearance of HIL on DWI.…”

Section: Discussionmentioning

confidence: 99%

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

Sato

Nakai

Tsurushima

et al. 2013

Neurol. Med. Chir.(Tokyo)

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“…Last, some experts recommended analyzing the clinical association with procedural time, the number of angiograms performed per intervention, and DPL. 20,[29][30][31] The exact time of each procedure was not included in our registry data base. According to our retrospective chart review, we could only obtain anesthesia time, not procedural time.…”

Section: Limitationsmentioning

confidence: 99%

Association between Postprocedural Infarction and Antiplatelet Drug Resistance after Coiling for Unruptured Intracranial Aneurysms

Ms¹,

Yeon³

et al. 2016

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Procedure-related thromboembolism is a major limitation of coil embolization, but the relationship between thromboembolic infarction and antiplatelet resistance is poorly understood. The purpose of this study was to verify the association between immediate postprocedural thromboembolic infarction and antiplatelet drug resistance after endovascular coil embolization for unruptured intracranial aneurysm.

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“…6 This has been confirmed by other investigators. 7,8 Moreover, silent cerebral embolism has also been shown in extracranial angiographic procedures. 9 Basically, embolic events during IA-DSA may be caused by either thromboembolism or air embolism introduced by injection of contrast medium or catheter flushing.…”

mentioning

confidence: 99%

Heparin and Air Filters Reduce Embolic Events Caused by Intra-Arterial Cerebral Angiography

et al. 2004

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Background-Intra-arterial cerebral angiography is associated with a low risk for neurological complications, but clinically silent ischemic events after angiography have been seen in a substantial number of patients. Methods and Results-In a prospective study, diffusion-weighted magnetic resonance imaging (DW-MRI) before and after intra-arterial cerebral angiography and transcranial Doppler sonography during angiography were used to evaluate the frequency of cerebral embolism. One hundred fifty diagnostic cerebral angiographies were randomized into 50 procedures, each using conventional angiographic technique, or systemic heparin treatment throughout the procedure, or air filters between the catheter and both the contrast medium syringe and the catheter flushing. There was no neurological complication during or after angiography. Overall, DW-MRI revealed 26 new ischemic lesions in 17 patients (11%). In the control group, 11 patients showed a total of 18 lesions. In the heparin group, 3 patients showed a total of 4 lesions. In the air filter group, 3 patients exhibited a total of 4 lesions. The reduced incidence of ischemic events in the heparin and air filter groups compared with the control group was significantly different (Pϭ0.002).Transcranial Doppler sonography demonstrated a large number of microembolic signals that was significantly lower in the air filter group compared with the heparin and control groups (PϽ0.01), which did not differ from each other. Conclusions-Air filters and heparin both reduce the incidence of silent ischemic events detected by DW-MRI after intra-arterial cerebral angiography and can potentially lower clinically overt ischemic complications. This may apply to any intra-arterial angiographic procedure.

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Ischemic lesions related to cerebral angiography: Evaluation by diffusion weighted MR imaging

Cited by 54 publications

References 10 publications

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

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

Association between Postprocedural Infarction and Antiplatelet Drug Resistance after Coiling for Unruptured Intracranial Aneurysms

Heparin and Air Filters Reduce Embolic Events Caused by Intra-Arterial Cerebral Angiography

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