Cerebral arteriography

Operations on the extracranial carotid artery are currently among the most frequently performed procedures in vascular surgery. Although the most common indication for carotid surgery is cerebrovascular insufficiency, a number of other disorders involving the carotid vessels require surgical treatment. Adequate arteriographic visualization of both the extracranial and intracranial vasculature is the cornerstone of the diagnostic armamentarium for the clinical evaluation that must be carried out prior to surgical consideration. Many satisfactory techniques for arteriography are now available. Knowledge of the complications related to cerebral arteriography and methods by which they may be prevented is mandatory if one is to obtain acceptable clinical results. Complications peculiar to this field may be disastrous. This is especially true when performing arteriographic studies on a patient who has had an acute stroke whose condition may be worsened by the procedure or on a patient with transient ischemic attacks or asymptomatic carotid bruits who, prior to the problem, had no demonstrable neurologic deficit but who may incur a paralytic stroke as a result of the diagnostic study