Complications of Diagnostic Intra-arterial Cerebral Angiography in Ischemic Cerebrovascular Diseases

Lee, Kyung Yul; Kim, Seo Hyun; Yoon, Pyeong Ho; Kim, Dong Ik; Lee, Byung In; Kim, Seung Min; Park, Soo Chul; Sohn, Young Ho; Heo, Ji Hoe

Abstract

BACKGROUND: Intra-arterial cerebral angiography, which is a prerequisite for carotid endarterectomy and angioplasty, carries some risks but provides the best visualization of the cerebral vasculatures. We attempted to examine the inci-dence of complications associated with cerebral angiography in patients with ischemic stroke.
METHODS
We retrospec-tively reviewed the medical records of patients with ischemic stroke or transient ischemic attack (TIA) who underwent the digital subtraction cerebral angiography. Four hundred nineteen procedures were performed between October 1994 and August 1999. The systemic, local, and neurologic complications were evaluated. The neurologic complications were defined as occurrences of any new focal neurologic deficits or progressions of the preexisting neurologic deficits during or within 24 hours after the procedure.
RESULTS
There were 5 systemic (1.2%), 17 local (4.1%), and 10 neuro-logic (2.4%) complications. The neurologic complications were reversible within 7 days in 6 (1.4%) and were persistent after 7 days in 4 (1.0%). Six out of 10 patients with neurologic complications had previous stroke or TIA. The angio-graphic studies revealed the stenosis or obstruction of the relevant arteries in 7 patients.
CONCLUSIONS
Cerebral angiog-raphy in patients with ischemic stroke was associated with 1.4 % reversible and 1.0% persistent neurologic complica-tions, all of which developed after the angiographic procedure. The history of previous stroke or TIA and the presence of severe stenosis or occlusion of the symptomatic arteries may carry a high risk of neurologic complications. (J Korean Neurol Assoc 19(4):354~358, 2001)