Acute management and outcomes of iatrogenic dissections during cerebral angiography

Andrew P Groves; Akash P Kansagra; Dewitte T Cross III; Christopher J Moran; Colin P Derdeyn

doi:10.1136/neurintsurg-2016-012285

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Acute management and outcomes of iatrogenic dissections during cerebral angiography

Journal article

Peer reviewed

Acute management and outcomes of iatrogenic dissections during cerebral angiography

Andrew P Groves, Akash P Kansagra, Dewitte T Cross III, Christopher J Moran and Colin P Derdeyn

Journal of neurointerventional surgery, Vol.9(5), pp.499-501

05/2017

DOI: 10.1136/neurintsurg-2016-012285

PMID: 27084963

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Abstract

Iatrogenic dissection is a known complication of cerebral angiography, but the clinical outcomes and optimal treatment of these patients is not well established. We sought to review our experience with cerebral angiography to determine the incidence of iatrogenic dissections along with clinical outcomes associated with a generally conservative treatment strategy. We retrospectively reviewed clinical records for all patients that underwent cerebral angiography between March 2002 and May 2015. Demographic information, angiography reports, follow-up CT and MRI reports, and follow-up clinical notes were reviewed. 17 418 cerebral angiograms were performed during the review period, including 13 485 diagnostic angiograms and 3933 endovascular interventional procedures. 68 iatrogenic dissections were identified, for a per procedure incidence of 0.39%. The vertebral artery was the most commonly dissected vessel (49/68, 72%). 67 of 68 cases (98.5%) were managed conservatively with either no treatment or medical therapy alone. There were two adverse events potentially attributable to the dissections, only one of which was symptomatic. Iatrogenic dissections occur infrequently during cerebral angiography. When dissections do occur, most cases can be safely managed without further intervention in the acute setting.

Follow-Up Studies

Vertebral Artery Dissection - etiology

Carotid Artery, Internal, Dissection - etiology

Humans

Middle Aged

Vertebral Artery Dissection - therapy

Male

Treatment Outcome

Cerebral Angiography - trends

Carotid Artery, Internal, Dissection - diagnosis

Cerebral Angiography - adverse effects

Endovascular Procedures - methods

Carotid Artery, Internal, Dissection - therapy

Adult

Female

Vertebral Artery Dissection - diagnosis

Aged

Disease Management

Retrospective Studies

Iatrogenic Disease

Details

Title: Subtitle: Acute management and outcomes of iatrogenic dissections during cerebral angiography
Creators: Andrew P Groves - Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Missouri, USA
Akash P Kansagra - Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Missouri, USA
Dewitte T Cross III - Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Missouri, USA
Christopher J Moran - Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Missouri, USA
Colin P Derdeyn - Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Missouri, USA
Resource Type: Journal article
Publication Details: Journal of neurointerventional surgery, Vol.9(5), pp.499-501
Publisher: England
DOI: 10.1136/neurintsurg-2016-012285
PMID: 27084963
ISSN: 1759-8478
eISSN: 1759-8486
Language: English
Date published: 05/2017
Academic Unit: Neurology; Radiology; Stead Family Department of Pediatrics; Iowa Neuroscience Institute; Hematology/Oncology; Neurosurgery
Record Identifier: 9984020643402771

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