Audit of diagnostic and interventional craniocervical catheter angiographic procedures at the Singapore General Hospital

Ann Acad Med Singap. 2004 Sep;33(5):607-13.

Abstract

Introduction: Catheter angiography is an established imaging modality of evaluating cerebral and head and neck vascular diseases. It is, however, an invasive procedure with a small risk of complications. The aim of our study was to evaluate the prevalence of peri-procedural complications in a local hospital setting.

Materials and methods: A total of 88 patients underwent diagnostic and interventional craniocervical procedures over 6 months in our department. The casenotes of 83 patients were retrospectively reviewed for complications arising from a total of 99 procedures carried out.

Results: A new focal neurological deficit developed in 3 different patients after a procedure, giving a prevalence of 3.0%. All these occurred in diagnostic procedures and were permanent deficits with correlative computed tomography (CT) or magnetic resonance (MR) imaging findings of acute cerebral infarction. All these occurred in high-risk patients who had severe underlying cerebrocarotid vascular compromise. There was 1 case of contrast medium-induced nephropathy (1.0%), occurring in a patient with pre-existing renal impairment. Local complications included 1 case of iatrogenic external iliac artery dissection (1.0%) and 5 cases (5.1%) of small and uncomplicated puncture site groin haematomas.

Conclusion: The most significant complication associated with a craniocervical angiographic procedure was the development of post-procedural stroke in patients with significant preexisting cerebrocarotid vascular compromise. In the absence of this risk factor, craniocervical catheter angiography is a relatively safe procedure.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Angioplasty, Balloon / instrumentation
  • Angioplasty, Balloon / methods
  • Cerebral Infarction / diagnostic imaging*
  • Cerebral Infarction / therapy*
  • Child
  • Child, Preschool
  • Embolization, Therapeutic / adverse effects
  • Embolization, Therapeutic / methods
  • Female
  • Hospitals, General / standards
  • Humans
  • Magnetic Resonance Angiography / adverse effects
  • Magnetic Resonance Angiography / methods*
  • Male
  • Medical Audit*
  • Middle Aged
  • Probability
  • Prognosis
  • Radiography, Interventional / adverse effects
  • Radiography, Interventional / methods*
  • Retrospective Studies
  • Risk Assessment
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Stents
  • Treatment Outcome