Low rate of complications of cerebral angiography in routine clinical practice

Objective: The use of cerebral angiography (ANGIO) to select patients for c arotid endarterectomy (CEA) has been limited by concern about the risk of c omplications of the procedure. The authors sought to determine the rate of neurologic complications at both an academic medical center (AMC) and a com munity hospital (CH). Methods: The authors reviewed the records of 569 pati ents undergoing ANGIO. Any documentation of stroke, transient neurologic ev ent, myocardial infarction, or death occurring in the 24 hours after the pr ocedure was recorded. The rate of neurologic complications at the AMC and C H were compared to published studies. Results: The overall complication rat e was 0.5% for stroke and 0.4% for TIA. There was no difference between the AMC and CH. One of the strokes was of moderate severity and four of the fi ve patients with complications subsequently underwent endarterectomy. Concl usions: The rate of major neurologic complications due to ANGIO may be lowe r than expected, even when performed in a non-academic setting. Awareness o f local ANGIO complication rates is important when selecting patients for C EA.