The Risks and Complications Associated with Cerebral Angiography

Cerebral angiography is a diagnostic procedure that carries a relatively low level of risk overall. However, as an invasive test, it is not without potential complications. One of the most commonly reported risks in clinical settings is the occurrence of ischemic events. For example, during the procedure, catheter manipulation may cause vasospasm—narrowing of the blood vessels—leading to reduced blood flow to the brain and potential ischemia.

Possible Vascular Complications

Additionally, the use of catheters and guidewires may lead to thromboembolism or air embolism. In some cases, these instruments can dislodge arterial plaques during insertion, resulting in plaque fragments traveling to the brain and causing cerebral embolism. These events, although rare, can lead to serious neurological consequences such as stroke or transient ischemic attack (TIA).

Local and Systemic Risks

Beyond the vascular system, complications at the puncture site are also possible. These may include bruising, hematoma formation, or more severe bleeding from a major artery. Moreover, the iodine-based contrast agents used during the procedure can sometimes cause adverse reactions, particularly in patients with pre-existing kidney conditions. This may result in temporary or, in rare cases, long-term renal dysfunction.

Risk of Increased Intracranial Pressure

In very rare instances, slight changes in intracranial pressure during the procedure could potentially trigger the rupture of an aneurysm or other vascular abnormalities. However, it is important to note that the likelihood of such an event is extremely low and typically associated with pre-existing high-risk conditions.

Exposure to Ionizing Radiation

As with any procedure involving X-rays, cerebral angiography exposes patients to a small amount of ionizing radiation. While the dose is generally considered safe, cumulative exposure over time may pose a minor risk, particularly for patients undergoing repeated imaging studies.

In summary, while cerebral angiography is a valuable diagnostic tool, it is essential for both physicians and patients to be aware of the potential risks involved. With proper patient selection, skilled technique, and appropriate monitoring, these risks can be minimized, ensuring a safer outcome.