Abstract Details

Title The Current Role and Utility of Diagnostic Catheter Cerebral Angiography

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P02 - (-)

Poster/Presentation
Number 021

Objective

Background BACKGROUND: As the oldest of the currently available in vivo brain vascular imaging modalities, the role and utility of catheter cerebral angiography has changed with improvements in noninvasive imaging modalities such as computed tomography and magnetic resonance angiography.

Design/Methods DESIGN/METHODS: We performed an observational, retrospective, single-center study of consecutive adult patients undergoing diagnostic digital subtraction angiography (DSA) at a tertiary care urban medical center. We prospectively recorded the indications for the angiogram and any type of noninvasive brain vascular imaging done prior. We recorded the findings seen, whether or not these were new, and if these findings led to any change in the management.

Results RESULTS: From February 2011 to October 2011, we reviewed 200 consecutive diagnostic DSAs. Among the surveillance angiograms 89/200 (44.5%), done after prior treatment, 28 (31.5%) had findings that changed management. The indications of the remaining 111/200 cases were for the evaluation of subarachnoid hemorrhage (SAH) in 27 (13.5%), ischemic stroke in 15 (7.5%), and 13 (6.5%) each for intracerebral hemorrhage (ICH), cerebral aneurysm and arteriovenous malformation (AVM). The remaining 30 cases (15%) included tumors, vascular stenosis, sinus thrombosis, dissection, fistula, spinal AVM and vasculopathy. Non-surveillance DSA yielded new findings in 52 (46.8%) cases, with those done for cerebral aneurysms and AVMs yielding the highest rate of new findings (69.2% each).

Conclusions CONCLUSIONS: Despite the increased use and availability of noninvasive brain vascular imaging, DSA continues to be used in a variety of indications and appears to yield additional meaningful information despite prior imaging about 30-40% of the time on average. Particularly in those conditions where more precise spatial and temporal resolution would be of theoretical benefit, we did observe a higher percentage of new findings.

Authors/Disclosures
Nader Sawiris, MD PRESENTER	No disclosure on file
Alexander Venizelos, MD	No disclosure on file
	No disclosure on file
Michael Chen, MD (Rush University Medical Center)	Dr. Chen has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Medtronic. Dr. Chen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for RapidPulse. Dr. Chen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cerenovus. Dr. Chen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Balt. Dr. Chen has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Genentech. Dr. Chen has received personal compensation in the range of $0-$499 for serving as an officer or member of the Board of Directors for Society of Neurointerventional Surgery. Dr. Chen has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Journal of Neurointerventional Surgery. Dr. Chen has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Johnson.
Tracy T. Batchelor, MD, MPH (Brigham and Women's Hospital)	Dr. Batchelor has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Up To Date, Inc. An immediate family member of Dr. Batchelor has received publishing royalties from a publication relating to health care. Dr. Batchelor has received publishing royalties from a publication relating to health care.

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