Safety of Arch Aortography for Assessment of Carotid Arteries

PurposeTo retrospectively review the safety of arch aortography and compare complication rates with published figures for selective catheter angiography.MethodsThe medical records of patients undergoing arch aortography over the last 3 years (n=311; 180 male, 131 female; mean±SD age 71.0±9.2 years, range 42–90 years) were retrospectively reviewed. Any peri-procedural (0–48 h) complications were recorded. A certified neurologist (MSR/GSV) classified all questionable neurological events.ResultsThere were no focal neurological events or deaths (n=0; 0%; CI: 0–0.96%). Non-focal neurological events included mild disorientation (n=2; 0.6%; CI: 0.176–2.31) and unequal pupils (n=1; 0.3%; CI: 0.056–1.79%). Cardiovascular events included symptomatic hypotension (n=4; 1.3%; CI: 0.50–3.25%), angina (n=1; 0.3%; CI: 0.056–1.79%) and arrhythmia (n=4; 1.3%; CI: 0.50–3.25). There were 27 minor access site complications (8.7%; CI: 6.0–12.3). None of these complications extended hospital stay. None of the arch angiograms had to be followed by selective carotid angiography.ConclusionArch aortography appears to have a lower neurological complication rate than selective carotid angiography.