Complications of Carotid Arteriography

Abstract

Introduction Opinions vary about the hazard of carotid arteriography, especially in those patients with cerebral ischemia whether secondary to occlusive arterial disease, arterial spasm following subarachnoid hemorrhage, or vascular headache of the migraine type. In 1957, Riishede concluded after a detailed study of 100 patients with cerebral infarction that "the risk (of arteriography) is not greater than in any general neurosurgical material."¹ However, in 1959, McDowell et al found a high morbidity of 20%, resulting from carotid arteriography in 68 patients with cerebrovascular disease. These authors urged caution in the use of arteriography, particularly in patients who were stuporous or whose condition was deteriorating following a stroke.² To prevent the occurrence of these complications various authors have stressed the value of using small amounts of dye, restricting the number of injections, and performing the procedure under general anesthesia. In order to assess the risk involved and the