CEREBRAL-ANGIOGRAPHY PRACTICES AT US TEACHING HOSPITALS - IMPLICATIONS FOR CAROTID ENDARTERECTOMY

Background and Purpose Although several clinical trials of carotid end arterectomy (CE) have been carried out in the last decade, the methods for angiographic measurement of carotid stenosis have not been standa rdized. How one measures carotid stenosis may affect the applicability of clinical trial results. We sought to obtain information on cerebra l angiography practices at teaching hospitals in the United States. Me thods We surveyed hospitals with an accredited radiology residency pro gram. Results Of the 200 radiology program directors who were sent the survey, 97 responded. The angiographic complication rate was known in 68 of 97 medical centers and averaged 0.6%. The most common method be ing used for measurement of carotid stenosis is the NASCET method (70% ). Forty-two of 97 program directors reported a decrease in the volume of angiography being performed. Of these 42, one third reported that CE was commonly being performed on the basis of noninvasive tests alon e. Conclusions The angiographic complication rate at American teaching hospitals is within the ''acceptable'' range. The NASCET method of st enosis measurement is the most popular among academic radiologists. Th e volume of cerebral angiography appears to be decreasing. How these d ata compare with community hospitals without an accredited radiology r esidency program warrants further study.