Cerebral angiographic risk in mild cerebrovascular disease

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Stroke. 1990;21:209-222

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ARTICLES

Cerebral angiographic risk in mild cerebrovascular disease

GJ Hankey, CP Warlow and RJ Sellar
Department of Clinical Neurosciences, Western General Hospital, Edinburgh, United Kingdom.

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 (less than 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.

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				K. Nael, J. P. Villablanca, L. Mossaz, W. Pope, A. Juncosa, G. Laub, and J. P. Finn 3-T Contrast-Enhanced MR Angiography in Evaluation of Suspected Intracranial Aneurysm: Comparison with MDCT Angiography Am. J. Roentgenol., February 1, 2008; 190(2): 389 - 395. [Abstract] [Full Text] [PDF]

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				T. J. Kaufmann, J. Huston III, J. N. Mandrekar, C. D. Schleck, K. R. Thielen, and D. F. Kallmes Complications of Diagnostic Cerebral Angiography: Evaluation of 19 826 Consecutive Patients Radiology, June 1, 2007; 243(3): 812 - 819. [Abstract] [Full Text] [PDF]

				K. Nael, J. P. Villablanca, W. B. Pope, T. O. McNamara, G. Laub, and J. P. Finn Supraaortic Arteries: Contrast-enhanced MR Angiography at 3.0 T--Highly Accelerated Parallel Acquisition for Improved Spatial Resolution over an Extended Field of View Radiology, February 1, 2007; 242(2): 600 - 609. [Abstract] [Full Text] [PDF]

				D.Y. Yoon, K.J. Lim, C.S. Choi, B.M. Cho, S.M. Oh, and S.K. Chang Detection and Characterization of Intracranial Aneurysms with 16-Channel Multidetector Row CT Angiography: A Prospective Comparison of Volume-Rendered Images and Digital Subtraction Angiography AJNR Am. J. Neuroradiol., January 1, 2007; 28(1): 60 - 67. [Abstract] [Full Text] [PDF]

				R.L. Cuffe and P.M. Rothwell Effect of Nonoptimal Imaging on the Relationship Between the Measured Degree of Symptomatic Carotid Stenosis and Risk of Ischemic Stroke Stroke, July 1, 2006; 37(7): 1785 - 1791. [Abstract] [Full Text] [PDF]

				P. Shannon, J.M. Billbao, T. Marotta, and K. Terbrugge Inadvertent Foreign Body Embolization in Diagnostic and Therapeutic Cerebral Angiography. AJNR Am. J. Neuroradiol., February 1, 2006; 27(2): 278 - 282. [Abstract] [Full Text] [PDF]

				P S Sidhu, P L Allan, F Cattin, D O Cosgrove, A H Davies, D D Do, S Karakagil, J Langholz, D A Legemate, A Martegani, et al. Diagnostic efficacy of SonoVue(R), a second generation contrast agent, in the assessment of extracranial carotid or peripheral arteries using colour and spectral Doppler ultrasound: a multicentre study Br. J. Radiol., January 1, 2006; 79(937): 44 - 51. [Abstract] [Full Text] [PDF]

				P Collins, I McKay, S Rajagoplan, P Bachoo, O Robb, and J Brittenden Is carotid duplex scanning sufficient as the sole investigation prior to carotid endarterectomy? Br. J. Radiol., November 1, 2005; 78(935): 1034 - 1037. [Abstract] [Full Text] [PDF]

				D. C. Heasley, M. A. Mohamed, and D. M. Yousem Clearing of Red Blood Cells in Lumbar Puncture Does Not Rule Out Ruptured Aneurysm in Patients with Suspected Subarachnoid Hemorrhage but Negative Head CT Findings AJNR Am. J. Neuroradiol., April 1, 2005; 26(4): 820 - 824. [Abstract] [Full Text] [PDF]

				B. Chu, T. S. Hatsukami, N. L. Polissar, X.-Q. Zhao, L. W. Kraiss, D. L. Parker, J. C. Waterton, J. S. Raichlen, W. Hamar, and C. Yuan Determination of Carotid Artery Atherosclerotic Lesion Type and Distribution in Hypercholesterolemic Patients With Moderate Carotid Stenosis Using Noninvasive Magnetic Resonance Imaging Stroke, November 1, 2004; 35(11): 2444 - 2448. [Abstract] [Full Text] [PDF]

				H.-S. Kang, M. H. Han, B. J. Kwon, S. I. Jung, C.-W. Oh, D. H. Han, and K.-H. Chang Postoperative 3D Angiography in Intracranial Aneurysms AJNR Am. J. Neuroradiol., October 1, 2004; 25(9): 1463 - 1469. [Abstract] [Full Text] [PDF]

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				P. J. Nederkoorn, O. E. H. Elgersma, Y. van der Graaf, B. C. Eikelboom, L. J. Kappelle, and W. P. T. M. Mali Carotid Artery Stenosis: Accuracy of Contrast-enhanced MR Angiography for Diagnosis Radiology, September 1, 2003; 228(3): 677 - 682. [Abstract] [Full Text] [PDF]

				P. M. Rothwell For Severe Carotid Stenosis Found on Ultrasound, Further Arterial Evaluation Prior to Carotid Endarterectomy Is Unnecessary: The Argument Against Stroke, July 1, 2003; 34(7): 1817 - 1819. [Full Text] [PDF]

				W. S. Moore For Severe Carotid Stenosis Found on Ultrasound, Further Arterial Evaluation Is Unnecessary Stroke, July 1, 2003; 34(7): 1816 - 1817. [Full Text] [PDF]

				K. Yoshida, K. Nozaki, K.-i. Kikuta, A. Sadato, S. Miyamoto, and N. Hashimoto Contrast-Enhanced Carotid Color-Coded Duplex Sonography for Carotid Stenting Follow-Up Assessment AJNR Am. J. Neuroradiol., May 1, 2003; 24(5): 992 - 995. [Abstract] [Full Text] [PDF]

				J. Alvarez-Linera, J. Benito-Leon, J. Escribano, J. Campollo, and R. Gesto Prospective Evaluation of Carotid Artery Stenosis: Elliptic Centric Contrast-Enhanced MR Angiography and Spiral CT Angiography Compared with Digital Subtraction Angiography AJNR Am. J. Neuroradiol., May 1, 2003; 24(5): 1012 - 1019. [Abstract] [Full Text] [PDF]

				G.C. Cloud and H.S. Markus Diagnosis and management of vertebral artery stenosis QJM, January 1, 2003; 96(1): 27 - 54. [Full Text] [PDF]

				G. Schulte-Altedorneburg, D. W. Droste, S. Felszeghy, L. Csiba, V. Popa, K. Hegedus, J. Kollar, L. Modis, and E. B. Ringelstein Detection of Carotid Artery Stenosis by In Vivo Duplex Ultrasound: Correlation With Planimetric Measurements of the Corresponding Postmortem Specimens Stroke, October 1, 2002; 33(10): 2402 - 2407. [Abstract] [Full Text] [PDF]

				H. Kiyosue, M. Okahara, H. Nagatomi, T. Nakamura, S. Tanoue, and H. Mori 3.3F Catheter/Sheath System for Use in Diagnostic Neuroangiography AJNR Am. J. Neuroradiol., April 1, 2002; 23(4): 711 - 715. [Abstract] [Full Text] [PDF]

				E. Ballotta, G. Da Giau, C. Baracchini, A. I. Qureshi, M.F. K. Suri, Z. Ali, S. H. Kim, and L.N. Hopkins *An Unjustified Return to the Past Response** Stroke, March 1, 2002; 33(3): 879 - 881. [Full Text] [PDF]

				K. Logason, S. Karacagil, H.-G. Hardemark, A. Bostrom, A. Hellberg, and C. Ljungman Carotid Artery Endarterectomy Solely Based on Duplex Scan Findings Vascular and Endovascular Surgery, January 1, 2002; 36(1): 9 - 15. [Abstract] [PDF]

				K-T Khaw and P D Griffiths Non-invasive imaging of the cervical carotid and vertebral arteries Imaging, December 15, 2001; 13(5): 376 - 390. [Abstract] [Full Text] [PDF]