NEUROLOGIC COMPLICATIONS OF CEREBRAL-ANGIOGRAPHY

PURPOSE: To examine the incidence of neurologic complications associat ed with modem cerebral angiography and to assess patient characteristi cs associated with an increased risk of complications. METHODS: One th ousand consecutive cerebral angiographic procedures were evaluated pro spectively. Examinations were performed using transfemoral catheteriza tion and film-screen methods. For purposes of this trial, a neurologic complication was defined as any new focal neurologic deficit or chang e in mental status occurring during the angiogram or within the follow ing 24 hours. Patients were evaluated during and at the completion of angiography. Follow-up evaluations were performed on the day of and th e day after angiography. RESULTS: There were a total of 10 neurologic complications within 24 hours of angiography, 5 of which were persiste nt. Onset of 5 of the deficits occurred during angiography, the other 5 (3 persistent) were delayed. All complications occurred in patients being evaluated for stroke/transient ischemic attack or (in one case) asymptomatic bruit. A higher average age, longer average procedure tim e, and greater volume of radiographic contrast was noted in these pati ents than in the study population. CONCLUSION: Cerebral angiography wa s associated with a 1% overall incidence of neurologic deficit and a 0 .5% incidence of persistent deficit. All complications occurred in pat ients presenting with a history of stroke/transient ischemic accident or carotid bruit, which may reflect the difficulty of performing angio graphy in this population at risk for atherosclerotic changes.