Angiographic Complications in Patients with Cerebrovascular Disease

Abstract

I N 1958 we first reported on our experiences in the use of sodium diatrizoate (Hypaque) for cerebral angiography. 3 At that time we were particularly interested in comparing morbidity and mortali ty among patients studied angiographically from the standpoint of the contrast material that was used in the examination. Of the various media available, we selected sodium diatrizoate for use because of results that were obtained in animal experimentation. All of the patients in the present study were investigated by Hypaque angiography. The purpose of this report is not only to suInmarize the effectiveness of sodium diatrizoatc as a contrast medium, but to consider the effectiveness as well as the dangers of cerebral angiography in the presence of ccrebrovascular disease. We have noticed in the past few years a progressive increase in the number of angiographic studies done as well as in the completeness of these studies (lone in any given patient. The one great impetus in this respect has been the recent incrcascd interest in patients presenting the stroke syndrome. ~ Since July 1, 1956 we have done routinely bilateral carotid angiography in all patients seen with the stroke syndrome. More recently, we have included eithcr 3-vessel or 4vessel angiography, i.e. bilateral carotid and percutaneous cervical vertebral, or bilateral carotid and bilateral retrograde brachialvertebral angiography. The brachial studies have been very helpful in evaluating the extent of occlusive vascular involvement in patients whose primary diagnosis was athero-