Heiserman J E, Dean B L, Hodak J A, Flom R A, Bird C R, Drayer B P, Fram E K
Barrow Neurological Institute of St. Joseph's Hospital and Medical Center, Phoenix, Ariz. 85013.
AJNR Am J Neuroradiol. 1994 Sep;15(8):1401-7; discussion 1408-11.
To examine the incidence of neurologic complications associated with modern cerebral angiography and to assess patient characteristics associated with an increased risk of complications.
One thousand consecutive cerebral angiographic procedures were evaluated prospectively. Examinations were performed using transfemoral catheterization and film-screen methods. For purposes of this trial, a neurologic complication was defined as any new focal neurologic deficit or change in mental status occurring during the angiogram or within the following 24 hours. Patients were evaluated during and at the completion of angiography. Follow-up evaluations were performed on the day of and the day after angiography.
There were a total of 10 neurologic complications within 24 hours of angiography, 5 of which were persistent. Onset of 5 of the deficits occurred during angiography, the other 5 (3 persistent) were delayed. All complications occurred in patients being evaluated for stroke/transient ischemic attack or (in one case) asymptomatic bruit. A higher average age, longer average procedure time, and greater volume of radiographic contrast was noted in these patients than in the study population.
Cerebral angiography was associated with a 1% overall incidence of neurologic deficit and a 0.5% incidence of persistent deficit. All complications occurred in patients presenting with a history of stroke/transient ischemic accident or carotid bruit, which may reflect the difficulty of performing angiography in this population at risk for atherosclerotic changes.
研究现代脑血管造影术相关神经并发症的发生率，并评估与并发症风险增加相关的患者特征。
前瞻性评估连续1000例脑血管造影手术。采用经股动脉插管和屏-片摄影法进行检查。在本试验中，神经并发症定义为血管造影期间或之后24小时内出现的任何新的局灶性神经功能缺损或精神状态改变。在血管造影期间及结束时对患者进行评估。在血管造影当天和次日进行随访评估。
血管造影术后24小时内共有10例神经并发症，其中5例为持续性并发症。5例缺损在血管造影期间出现，另外5例（3例持续性）出现延迟。所有并发症均发生在因中风/短暂性脑缺血发作接受评估的患者中（1例为无症状杂音患者）。与研究人群相比，这些患者的平均年龄更高、平均手术时间更长、放射造影剂用量更大。
脑血管造影术的神经功能缺损总体发生率为1%，持续性缺损发生率为0.5%。所有并发症均发生在有中风/短暂性脑缺血发作病史或颈动脉杂音的患者中，这可能反映了对这一有动脉粥样硬化改变风险人群进行血管造影的难度。
