1089 Indications and Complications of Diagnostic Cerebral Angiogram in a Modern Academic Practice

INTRODUCTION: Several series have reported on the complication rates of diagnostic cerebral angiography (DCA). Changes in procedural indications, catheter technologies, and access methods necessitate an investigation into the demographics and complications of DCA in a modern practice. METHODS: A retrospective review was conducted of patients who underwent DCA between 2013 and 2020. Demographics, clinical information, procedural information, and complications were collected. Multivariate analysis was utilized to identify potential factors associated with complications. RESULTS: A total of 1,605 DCA were performed. The mean age of patients was 57±15 years old, with 56% being females. The indications were 40% intracranial aneurysm, 19% shunting lesions, 18% intracranial hemorrhages, 4% non-atherosclerotic vasculopathy, 14% atherosclerotic vasculopathy or other ischemic diseases, and 5% others. During this time, the majority of DCA was performed via femoral access (84%), followed by radial access (16%). The mean procedural time was 34±32 minutes. Intraprocedural dissections occurred in 0.3%. There were 0.5% post-procedural neurologic complications and 0.4% postoperative access site complications requiring intervention. Radiographic dissection was diagnosed in 0.1% cases after DCA. After adjusting for age, sex, comorbidities, and access routes, the only statistically significant factors associated with complications were procedure time (aOR 1.01 [95%CI 1.00-1.01], p=0.02) and history of prior TIA/strokes (aOR 1.74 [95%CI 1.11-2.74], p=0.02). CONCLUSIONS: The relative distribution of indications for DCA has changed substantially from the time of publication of the largest DCA series to date, where the highest proportions of indications were atherosclerotic cerebrovascular disease and tumor evaluation. In a modern-day practice, procedural complication rates remain exceedingly low.