Aortocervical angiography in occlusive cerebrovascular disease

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Abstract
Fifty-five patients with clinical evidence of occlusive cerebrovascular disease were examined by aortocervical angiography. Occlusions and severe stenoses in extracranial portions of one or several of the arteries of the brain were noted in 60 per cent of the cases. Vascular lesions of all degrees were commonest in the vertebral arteries, showing a predilection for their origin from the subclavian artery. In 50 patients, the cerebral lesion could on clinical grounds be localized to a particular vascular system. The suspected vessel was occluded or severely stenosed in 50% of them. Only in 1 of the 25 cases in which aortocervical angiography had given a negative result was a satisfactory explanation of the cerebral ischemia obtained by selective angiography of the relevant vessel. Aortocervical angiography makes it possible to examine the entire course of the cerebral arteries from the aorta to the base of the brain and provides detailed and reliable information regarding the anatomy of the vessel walls. The examination is carried out at 1 sitting and no intervention is performed on the cerebral arteries. The contrast medium is injected in the aorta slightly below the middle of the ascending aorta through a catheter inserted by way of a femoral artery. Practically no risk of cerebral complications is involved.

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