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Neurology. 2011 Sep 27;77(13):1235-40. doi: 10.1212/WNL.0b013e3182302068. Epub 2011 Sep 14.

Safety of spinal angiography: complication rate analysis in 302 diagnostic angiograms.

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  • 1Nelson Building B-100, 600 N. Wolfe St, Johns Hopkins Hospital, Baltimore, MD 21287, USA.

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.

PMID:
21917768
[PubMed - indexed for MEDLINE]
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