COMPLICATIONS OF 337 PERCUTANEOUS VERTEBRAL ANGIOGRAPHIES

Abstract

After a short description of the arteriographic technique and the results obtained in 337 percutaneous vertebral arteriographies, the complications of these investigations are described. A total of 18 were found, of which 3 were general, 8 local, and 7 cerebral. Six patients with local complications had irritation of the brachial plexus, one also developed paroxysmal tachycardia, and another developed a permanent reflex dystrophy; and 2 cases of arteriovenous fistula. In these patients the investigations had been carried out by less experienced neuroradiologists. It is suggested that percutaneous vertebral arteriography should only be performed by fully qualified, experienced investigators. There were 3 mild cerebral complications: vertigo, increased migraine, and occipital lobe dysfunction; 4 severe: monoplegia, increasing brain stem symptoms, and 2 cases of coma and death. The 3 mild and the first 2 of the severe complications were all transient. As all the 4 patients who developed severe cerebral complications showed evidence of vertebral-basilar insufficiency before the investigation, it is emphasized that the incidence of cerebral complications could be reduced if, as far as possible, such patients were not subjected to percutaneous vertebral arteriography.