Safety of spinal angiography: Complication rate analysis in 302 diagnostic angiograms

James Chen, Philippe Gailloud

Research output: Contribution to journalArticle

Abstract

Objective: Spinal digital subtraction angiography (SpDSA) continues to be the imaging gold standard for the evaluation of spinal cord vascular disorders. The safety of this procedure has a poor historical reputation and there are few current reports on complication rates. We hypothesized that modern SpDSA can be performed with an acceptably low risk of iatrogenic complications. Methods: In this retrospective series, we reviewed 302 consecutive spinal angiograms performed during a 10-year period at our institution for the frequency of intraprocedural and postprocedural neurologic, non-neurologic, and local complications. Indications for SpDSA, prior noninvasive imaging findings, and angiographic diagnoses for each case were assessed to evaluate the diagnostic contribution of the procedure. Results: There were no intraprocedural or postprocedural neurologic complications in the studied cohort. Systemic complications occurred in 2 cases (0.7%), in the form of back spasms in one patient and pulmonary edema in the other. Both recovered promptly and were discharged at baseline status. Access-site complications included 3 groin hematomas (1.0%), all managed conservatively. MRI findings showed 51% sensitivity and 83% specificity for spinal vascular malformations. A total of 31% of patients with the preangiographic diagnosis of transverse myelitis were found to have a vascular malformation. Conclusion: SpDSA carries very low risks of neurologic and systemic complications, while offering a gold-standard level of diagnostic confidence for the evaluation of the normal and pathologic vasculature of the spinal cord.

Original languageEnglish (US)
Pages (from-to)1235-1240
Number of pages6
JournalNeurology
Volume77
Issue number13
DOIs
StatePublished - Sep 27 2011

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ASJC Scopus subject areas

  • Clinical Neurology

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