The use of intraoperative angiography in the management of neurovascular disorders

Abstract

Objective: To review our experience of intraoperative angiography in dealing with neurovascular disorders and to substantiate the usefulness of this investigation. Method: From April 1999 to November 2000, 32 cases of intraoperative angiogram were studied. Results: Two out of 30 intraoperative angiograms were unsuccessful. The angiographic machine broke down during one of the attempts. In one patient, intimal dissection of the femoral artery was noted during the procedure and the study was abandoned; the patient recovered uneventfully. Among the 30 completed angiograms, 19 were for cerebral aneurysm, 10 for arteriovenous malformation (AVM) and one for extracranial–intracranial (EC-IC) bypass. There was no procedure-related complication. Among the 19 angiograms performed for cerebral aneurysms, total occlusion was confirmed in 14 patients (74%), residual aneurysms were detected in two patients (10%) and branch occlusions were detected in three patients (16%). Of the 10 angiograms performed for AVM, total removal was confirmed in nine (90%), whereas residual AVM was detected in one patient (10%). One intraoperative angiogram for EC-IC bypass confirmed the patency of the graft. Conclusions: The study showed that cerebral intraoperative angiography is safe and frequently reveals unclipped aneurysm necks, unexpected major vessel occlusion and residual AVM. Intraoperative cerebral angiography should be recommended as a standard practice for treating neurovascular disorders. Chinese Abstract Figure Chinese Abstract.