Introduction Most cerebral angiography (CA) procedures are performed in the hospital setting. Per SIR/ASNR/SNIS 2015 guidelines, acceptable success rate is 98%, with a 1–5% rate of complications requiring additional therapy. Due to procedural complexity, physicians have historically been reluctant to perform CA in the freestanding outpatient clinic. Here, we report the results of CA procedures performed in our private clinic in the past 11 years.
Methods In this retrospective study, we collected the data on all patients who underwent CA from 2008 to 2019 in our clinic. A total of 771 consecutive procedures were analyzed. All procedures were performed by board-certified interventional neuroradiologists and senior members of Society of Neurointerventional Surgery. SIR/ASNR/SNIS 2015 guidelines were used to classify complications. Main recorded variables are listed in table 1. Indication, comorbidities, sedative details, access route, catheter, guidewire and sheath details and use of contrast media were recorded. Pre- and post-procedure NIHSS scores were used to evaluate possible neurologic complication.
Results Patient demographics, procedure details and outcome measures are presented in table 1. Overall success rate was 100%. Among all performed procedures, one neurologic complication (0.1%) was reported (TIA). Of all reported non-neurologic complications, 4 (0.6%) were classified as major (all class C) and 3 (0.4%) as minor (all class A). This places our safety outcomes well above acceptable rates. Median follow up duration was 2 weeks.
Conclusion According to our results, CA in non-complicated cases can be safely performed outside of hospital setting by board-certified interventional neuroradiologists with high success rates and minimal complications that are comparable to MRA and CTA. Our result show that not only CA is safe in an office setting, but potentially safer than MRA and CTA when considering higher quality imaging, evaluation of collateral flow and diagnosis of many additional vascular diseases. Proper case selection for this setting plays an important role in achieving optimal results and minimizing complications.
Disclosures S. Razavi: None. E. Masangkay: None. N. Chelikam: None. U. Kelly-Tolley: None. L. Pierce: None. R. Malek: None. A. Padiar: None.
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