The Effect of Diagnostic Catheter Angiography on Outcomes of Acute Ischemic Stroke Patients Being Considered for Endovascular Treatment

Abstract

Background—The risk of catheter-based angiograms alone (non-therapeutic angiogram that does not
lead to therapeutic intervention) in acute ischemic stroke patients who are considered for endovascular
treatment is not well studied.
Methods—We compared the rates of neurological deterioration within 24 h; symptomatic intracranial
hemorrhage (ICH) within 30 h; acute kidney injury (AKI) and major non-ICH within five days; and functional independence (defined by modified Rankin scale of 0–2) at three months among subjects who underwent a non-therapeutic catheter-based angiogram with subjects who did not undergo catheter-based angiogram in a multicenter clinical trial. Logistic regression analyses was performed to adjust for age, baseline
Alberta stroke program early CT score (ASPECTS) strata (0–7 and 8–10), and baseline National Institutes
of Health Stroke Scale (NIHSS) score strata (≤9, 10–19, and ≥20).
Results—Compared with subjects who did not undergo any catheter-based angiogram (n = 222), 89 subjects who underwent a non-therapeutic catheter-based angiogram had similar adjusted rates of neurological
deterioration [odds ratio (OR) = 1; 95% confidence interval (CI) 0.4–2.3; p = 1] and symptomatic ICH (OR
= 0.4; 95% CI 0.1–1.8; p = 0.2). There was no difference in the adjusted rates of AKI, or non-ICH between
the two groups. The rate of functional independence at three months was significantly higher among the
patients who received a catheter-based angiogram (OR = 2; 95% CI 1.1–3.5; p = 0.016) after adjusting for
potential confounders.
Conclusion—Non-therapeutic catheter-based angiograms in acute ischemic stroke patients who are being
considered for endovascular treatment do not adversely affect patient outcomes.
Grant support—The study did not receive any grant support.
Conflict of interest—The authors declare that they have no conflict of interest.