1 - Neuroradiology Department, Centro Hospitalar de Lisboa Central, Lisboa, Portugal
European Congress of Radiology (ECR), 4-8 March 2015, Vienna, Austria
Published online. DOI: 10.1594/ecr2015/C-2591
Purpose: To review current indications for performing conventional cerebral angiography in the pediatric population.
To evaluate the rate of complications for diagnostic and therapeutic angiography in children.
Background: Conventional cerebral catheter angiography is increasingly being replaced by non-invasive vascular imaging methods. In the pediatric population, where radiation and contrast are a concern, catheter angiography is seldom per-formed, and has few indications, usually whenever endovascular intervention is necessary.
Imaging findings: We retrospectively reviewed our neurointervention department database from 2012 to 2014, and col-lected the total number of patients under 18 years old that had cerebral angiograms. We found a total of 30 patients, ages ranging from 4 months to 17 years old. Indications for cerebral angiogram were arterio-venous malformations (27%), cere-bral aneurysms (17%), facial vascular malformation (10%), vasculitis (10%), carotid-cavernous fistula (6,7%), vein of Galen Malformation (6,7%), cranial aneurysmal bone cyst (6,7%), and finally tumor embolization, petrous sinus venous sampling, venous thrombosis and acute stroke (3% each). A third of the patients had endovascular procedures in our series.No intra-procedural complication was noted. One patient had intracranial hemorrhage 2 hours after embolization of a vein of Galen malformation, secondary to probable venous occlusion, but recovered clinically. There were no other significant complications.
Conclusion: Catheter cerebral angiography has selected indications in the pediatric population. Arteriovenous malforma-tions and cerebral aneurysms were the main indications in our series, and served mainly for treatment planning.
Catheter cerebral angiography is safe to perform in children, and provides important diagnostic information on cerebro-vascular pathology. There are formal indications for endovascular treatment in children, such as vein of Galen malformation.