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Original research
Intraoperative angiography does not lead to increased rates of surgical site infections
  1. William R Stetler Jr,
  2. Thomas J Wilson,
  3. Wajd N Al-Holou,
  4. Adam Khan,
  5. B Gregory Thompson,
  6. Aditya S Pandey
  1. Department of Neurosurgery, University of Michigan Health System, Ann Arbor, Michigan, USA
  1. Correspondence to Dr Thomas J Wilson, Department of Neurosurgery, University of Michigan Health System, 1500 E. Medical Center Drive, Room 3552 Taubman Center, Ann Arbor, MI 48109-5338, USA; thowil{at}


Background Intraoperative angiography (IOA) is essential in evaluating residual aneurysm following clip ligation, but it does lead to an additional procedure which increases the duration of the procedure as well as increasing room traffic. We examined whether IOA during microsurgery is a risk factor for developing cranial surgical site infection.

Materials and methods A retrospective cohort study was performed of all patients undergoing craniotomy for aneurysm treatment between 2005 and 2012 at the University of Michigan. IOA was used at the surgeons’ discretion. The primary outcome of interest was occurrence of a surgical site infection and the secondary outcome of interest was clip repositioning following IOA. Variables including IOA were tested for their independent association with the occurrence of a surgical site infection.

Results During the study period 676 intracranial aneurysms were treated by craniotomy; IOA was used in 104 of these cases. There were a total of 20 surgical site infections, 2 in the IOA group (1.9%) and 18 in the non-IOA group (3.1%), indicating that IOA was not a statistically significant variable for infection (p=0.50). No additional single variable measured could be shown to have a statistically significant increase in infection, and there were no direct complications related to the use of IOA (stroke, dissection, perforation).

Conclusions IOA does not increase the risk of developing a surgical site infection. It can be conducted without exposing patients to an undue risk of infection.

  • Aneurysm
  • Angiography
  • Infection

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