Safety of cerebral digital subtraction angiography in children: Complication rate analysis in 241 consecutive diagnostic angiograms

Ingrid M. Burger, Kieran J. Murphy, Lori C. Jordan, Rafael J Tamargo, Philippe Gailloud

Research output: Contribution to journalArticle

Abstract

BACKGROUND AND PURPOSE - Catheter-based cerebral angiography remains an important diagnostic tool in the pediatric population, particularly considering the currently growing interest in diagnosing and treating cerebrovascular disorders in children. There are no recent estimates of the complication rate associated with modern diagnostic digital subtraction angiography (DSA) in the pediatric population. The purpose of this study was to estimate the rate of complications occurring during cerebral angiography in children. METHODS - Data from 241 consecutive pediatric cerebral angiograms performed at a single institution were entered into an institutional review board-approved database. Information on patient demographics, DSA indication, neurovascular diagnosis, and intra procedural and postprocedural complications was collected. RESULTS - Our population included 115 boys and 90 girls, with age ranging from 1 week to 18 years (mean±SD, 12±5 years). All angiograms were technically successful. No intraprocedural complication was noted; in particular, there was no occurrence of iatrogenic vessel injury (dissection) and no transient or permanent neurological deficit secondary to a thromboembolic event. One child with a complex dural arteriovenous fistula experienced a fatal intracranial rehemorrhage secondary to a posterior fossa varix rupture 3 hours after completion of an uneventful diagnostic angiogram. The rates of intraprocedural and postprocedural complications were therefore 0.0% (95% CI, 0.0% to 1.4%) and 0.4% (95% CI, 0.012% to 2.29%), respectively. CONCLUSIONS - The rate of immediate complications occurring during diagnostic cerebral angiography in children is very low. No intraprocedural complication was documented in the reported series. DSA performed by experienced angiographers is a safe procedure that can provide critical diagnostic information.

Original languageEnglish (US)
Pages (from-to)2535-2539
Number of pages5
JournalStroke
Volume37
Issue number10
DOIs
StatePublished - Oct 2006

Fingerprint

Cerebral Angiography
Digital Subtraction Angiography
Angiography
Safety
Pediatrics
Population
Central Nervous System Vascular Malformations
Cerebrovascular Disorders
Research Ethics Committees
Varicose Veins
Dissection
Rupture
Catheters
Demography
Databases
Wounds and Injuries

Keywords

  • Catheter-based angiography
  • Children
  • Complications

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Neuroscience(all)

Cite this

Safety of cerebral digital subtraction angiography in children : Complication rate analysis in 241 consecutive diagnostic angiograms. / Burger, Ingrid M.; Murphy, Kieran J.; Jordan, Lori C.; Tamargo, Rafael J; Gailloud, Philippe.

In: Stroke, Vol. 37, No. 10, 10.2006, p. 2535-2539.

Research output: Contribution to journalArticle

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T2 - Complication rate analysis in 241 consecutive diagnostic angiograms

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AU - Gailloud, Philippe

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N2 - BACKGROUND AND PURPOSE - Catheter-based cerebral angiography remains an important diagnostic tool in the pediatric population, particularly considering the currently growing interest in diagnosing and treating cerebrovascular disorders in children. There are no recent estimates of the complication rate associated with modern diagnostic digital subtraction angiography (DSA) in the pediatric population. The purpose of this study was to estimate the rate of complications occurring during cerebral angiography in children. METHODS - Data from 241 consecutive pediatric cerebral angiograms performed at a single institution were entered into an institutional review board-approved database. Information on patient demographics, DSA indication, neurovascular diagnosis, and intra procedural and postprocedural complications was collected. RESULTS - Our population included 115 boys and 90 girls, with age ranging from 1 week to 18 years (mean±SD, 12±5 years). All angiograms were technically successful. No intraprocedural complication was noted; in particular, there was no occurrence of iatrogenic vessel injury (dissection) and no transient or permanent neurological deficit secondary to a thromboembolic event. One child with a complex dural arteriovenous fistula experienced a fatal intracranial rehemorrhage secondary to a posterior fossa varix rupture 3 hours after completion of an uneventful diagnostic angiogram. The rates of intraprocedural and postprocedural complications were therefore 0.0% (95% CI, 0.0% to 1.4%) and 0.4% (95% CI, 0.012% to 2.29%), respectively. CONCLUSIONS - The rate of immediate complications occurring during diagnostic cerebral angiography in children is very low. No intraprocedural complication was documented in the reported series. DSA performed by experienced angiographers is a safe procedure that can provide critical diagnostic information.

AB - BACKGROUND AND PURPOSE - Catheter-based cerebral angiography remains an important diagnostic tool in the pediatric population, particularly considering the currently growing interest in diagnosing and treating cerebrovascular disorders in children. There are no recent estimates of the complication rate associated with modern diagnostic digital subtraction angiography (DSA) in the pediatric population. The purpose of this study was to estimate the rate of complications occurring during cerebral angiography in children. METHODS - Data from 241 consecutive pediatric cerebral angiograms performed at a single institution were entered into an institutional review board-approved database. Information on patient demographics, DSA indication, neurovascular diagnosis, and intra procedural and postprocedural complications was collected. RESULTS - Our population included 115 boys and 90 girls, with age ranging from 1 week to 18 years (mean±SD, 12±5 years). All angiograms were technically successful. No intraprocedural complication was noted; in particular, there was no occurrence of iatrogenic vessel injury (dissection) and no transient or permanent neurological deficit secondary to a thromboembolic event. One child with a complex dural arteriovenous fistula experienced a fatal intracranial rehemorrhage secondary to a posterior fossa varix rupture 3 hours after completion of an uneventful diagnostic angiogram. The rates of intraprocedural and postprocedural complications were therefore 0.0% (95% CI, 0.0% to 1.4%) and 0.4% (95% CI, 0.012% to 2.29%), respectively. CONCLUSIONS - The rate of immediate complications occurring during diagnostic cerebral angiography in children is very low. No intraprocedural complication was documented in the reported series. DSA performed by experienced angiographers is a safe procedure that can provide critical diagnostic information.

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