Spectrum of Complications and Complication Rates After Diagnostic Catheter Angiography in Neuroradiology

Tafelmeier, Svenja; Kesseler, Elisabeth; Iancu, Anca-Maria; Nikoubashman, Omid; Wiesmann, Martin

doi:10.1007/s00062-023-01273-3

Cited by 6 publications

(5 citation statements)

References 19 publications

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“…Our knowledge of the sources of contamination and the efficacy of potential mechanisms of avoidance is limited. Neuroangiographic procedures have not been the focus of attention with regard to bacterial contamination and have been reported to be associated with low complication rates [9]. However, potential non-microbial contamination has been reported [10].…”

Section: Discussionmentioning

confidence: 99%

Bacterial Contamination of Syringes and Fluids in Diagnostic and Interventional Neuroangiography

Wiesmann,

Honecker,

Fleu

et al. 2024

Tomography

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(1) Background: Bacterial contamination has been shown to occur during angiographies, although data on its frequency and relevance are sparse. Our aim was to evaluate the incidence of bacterial contamination of syringes used under sterile conditions during neuroangiographies. We sought to differentiate between contamination of the outside of the syringes and the inside and to detect the frequency, extent and germ spectrum of bacterial contamination. (2) Methods: We prospectively collected 600 samples from 100 neuroangiographies. Per angiography, fluid samples from the three routinely used syringes as well as the syringes themselves were analyzed. We analyzed the frequency and extent of contamination and determined the germ spectrum. (3) Results: The majority of samples (56.9%) were contaminated. There was no angiography that showed no contamination (0%). The outer surfaces of the syringes were contaminated significantly more frequently and to a higher extent than the inner surfaces. Both the frequency and extent of contamination of the samples increased with longer duration of angiographic procedures. Most of the bacterial species were environmental or skin germs (87.7%). (4) Conclusions: Bacterial contamination is a frequent finding during neuroangiographies, although its clinical significance is believed to be small. Bacterial contamination increases with longer duration of angiographic procedures.

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Section: Discussionmentioning

confidence: 99%

Bacterial Contamination of Syringes and Fluids in Diagnostic and Interventional Neuroangiography

Wiesmann,

Honecker,

Fleu

et al. 2024

Tomography

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“…Thus, it cannot be ruled out that in some of our patients, DWI lesions were already present before angiography, and that consequently, the true incidence of DWI lesions caused by angiography in our cohort is somewhat lower than 17%. Nevertheless, our data indicate that although our center was able to achieve an incidence of permanent neurological damage after an angiography as low as 0.13% [ 13 ], the frequency of asymptomatic cerebral ischemia is considerably higher.…”

Section: Discussionmentioning

confidence: 99%

“…However, lesions were found in areas of non-probed vessels in only 4 patients, whereas 55 patients displayed DR only in areas that were supplied by arteries probed during angiography. In a second study, also including data from 2340 consecutive neuroangiographies performed over a period of 10 years, we analyzed all technical and clinical complications observed [ 13 ]. However, we deliberately excluded asymptomatic DWI lesions in that study because MRI was available only for a subset of patients.…”

Section: Discussionmentioning

confidence: 99%

Frequency and Pattern of MRI Diffusion Restrictions after Diagnostic Catheter Neuroangiography

et al. 2023

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(1) Background: We investigated the frequency, location, and lesion size of diffusion restrictions (DR) in magnetic resonance imaging (MRI) of asymptomatic patients after diagnostic angiography and assessed risk factors for their occurrence. (2) Methods: We analyzed diffusion-weighted images (DWI) of 344 patients undergoing diagnostic angiographies in a neuroradiologic center. Only asymptomatic patients who received a magnetic resonance imaging (MRI) examination within seven days after the angiography were included. (3) Results: Asymptomatic infarcts on DWI were identified in 17% of the cases after diagnostic angiography. In these 59 patients, a total of 167 lesions were noted. The diameter of the lesions was 1–5 mm in 128 lesions, and 5–10 mm in 39 cases. Dot-shaped diffusion restrictions were found most frequently (n = 163, 97.6%). None of the patients had neurological deficits during or after angiography. Significant correlations were found between the occurrence of lesions and patient age (p < 0.001), history of atherosclerosis (p = 0.014), cerebral infarction (p = 0.026), or coronary heart disease/heart attack (p = 0.027); and the amount of contrast medium used (p = 0.047) and fluoroscopy time (p = 0.033). (4) Conclusions: With an incidence of 17%, we observed a comparatively high risk for asymptomatic cerebral ischemia after diagnostic neuroangiography. Further measures to reduce the risk of silent embolic infarcts and improve the safety of neuroangiography are warranted.

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“…Currently, catheter digital subtraction angiography (DSA) is considered the “gold standard” for assessing the vascularity of bone tumors 17 . Nevertheless, DSA is a time-consuming and invasive procedure 18 …”

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confidence: 99%

“…17 Nevertheless, DSA is a time-consuming and invasive procedure. 18 Recently, computed tomography perfusion (CTP) has emerged as a promising technique for visualizing and quantifying tumor blood supply. [19][20][21] CTP is based on the principle that the passage of contrast material through the tissue can be used to map blood flow by depicting the increase in tissue density.…”

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confidence: 99%

Computed Tomography Perfusion Combined With Preoperative Embolization for Reducing Intraoperative Blood Loss in Separation Surgery for Thoracolumbar Metastases

Zhou

Shen

et al. 2023

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Study Design. A prospective consecutive case study. Objective: This study aimed to assess the accuracy of computed tomography perfusion (CTP) in evaluating the vascularity of thoracolumbar metastases and to determine the impact of combining CTP with preoperative embolization on reducing intraoperative blood loss during separation surgery. Summary of Background Data. Surgery for thoracolumbar metastases is a complex procedure with the potential for substantial blood loss. Therefore, assessing tumor vascularity before surgery and taking measures to minimize intraoperative blood loss is essential. Methods. A total of 62 patients with thoracolumbar metastases were prospectively enrolled. All patients underwent separation surgery using the posterior approach. Prior to surgery, the vascularity of the metastases was evaluated using CTP. Based on the CTP results, patients were categorized into hypervascular and hypovascular groups. Preoperative angiography and embolization were performed for the hypervascular group. Clinical data were abstracted, including intraoperative blood loss, perioperative complications, VAS score, neurological status, and the accuracy of vascularity evaluation by CTP confirmed by angiography. Chi-square testing was used to compare categorical variables, while independent sample t-tests were employed to compare continuous variables, with paired t-tests were used to assess differences from preoperative to postoperative time points. Results. The mean intraoperative blood loss was 485±167 mL and 455±127.6 mL in the two groups, respectively. The accuracy of vascularity evaluation by CTP was 100%. In the hypervascular group, 80.6% of the patients experienced at least one level of improvement in neurological status, while the hypovascular group had 81.5% of patients with similar improvement. None of the patients experienced neurological deterioration. There was a significant reduction in VAS score in both groups after the operation. Conclusion. The vascularity of thoracolumbar metastases could be accurately evaluated using noninvasive CTP. When combined with preoperative embolization, this approach effectively and safely reduced intraoperative blood loss in the setting of separation surgery.

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Spectrum of Complications and Complication Rates After Diagnostic Catheter Angiography in Neuroradiology

Cited by 6 publications

References 19 publications

Bacterial Contamination of Syringes and Fluids in Diagnostic and Interventional Neuroangiography

Bacterial Contamination of Syringes and Fluids in Diagnostic and Interventional Neuroangiography

Frequency and Pattern of MRI Diffusion Restrictions after Diagnostic Catheter Neuroangiography

Computed Tomography Perfusion Combined With Preoperative Embolization for Reducing Intraoperative Blood Loss in Separation Surgery for Thoracolumbar Metastases

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