TY - JOUR
T1 - Safety of spinal angiography
T2 - Complication rate analysis in 302 diagnostic angiograms
AU - Chen, James
AU - Gailloud, Philippe
N1 - Funding Information:
J. Chen was supported by the Doris Duke Foundation Clinical Research Fellowship award. Dr. Gailloud serves on a scientific advisory boards for and holds stock/stock options in Artventive Medical; has served as a consultant for and received speaker honoraria from Codman Neurovascular; holds patents re: EOS device, endovascular closure device and Embosphere/Embogel, liquid embolic agent and dissolvent; performs spinal angiography as part of his clinical practice as an interventional neuroradiologist; and has received research support from Siemens Medical.
PY - 2011/9/27
Y1 - 2011/9/27
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=82255160647&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=82255160647&partnerID=8YFLogxK
U2 - 10.1212/WNL.0b013e3182302068
DO - 10.1212/WNL.0b013e3182302068
M3 - Article
C2 - 21917768
AN - SCOPUS:82255160647
SN - 0028-3878
VL - 77
SP - 1235
EP - 1240
JO - Neurology
JF - Neurology
IS - 13
ER -