Complications of intravenous digital subtraction angiography
J. B. Ball Jr, R. R. Lukin, T. A. Tomsick and A. A. Chambers
Extracranial carotid occlusive disease can be evaluated with either
intravenous (IV) digital subtraction angiography (DSA) or standard
angiography. In a prospective study, complications related to 500 IV DSA
examinations occurred in 16.6% of patients, including local complications
in 2.0%, systemic complications in 15.0%, and neurologic complications in
3.0%. A permanent neurologic deficit occurred in one patient. Complications
related to 150 standard angiograms occurred in 7.3% of patients, including
local complications in 4.0%, systemic complications in 3.4%, and neurologic
complications in 0.7%. There were no permanent neurologic deficits. Serious
systemic and neurologic complications occurred in 8.2% of patients during
IV DSA and 2.7% of patients during standard angiography. The rapid
injection of high volumes of hypertonic contrast media during IV DSA and
the resultant hemodynamic and cardiac electrophysiologic changes account
for the higher incidence of complications with IV DSA.
