What is the role of catheter cerebral angiography in the evaluation of posterior cerebral artery (PCA) stroke?

Updated: Jul 30, 2018
  • Author: Erek K Helseth, MD; Chief Editor: Helmi L Lutsep, MD  more...
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Answer

Catheter cerebral angiography remains the criterion standard for evaluation of vascular anatomy. However, it is a more invasive method and does carry a small risk of procedure-related morbidity.

Increasingly, noninvasive methods of viewing the arterial anatomy (CTA, MRA, transcranial Doppler [TCD] ultrasonography) are being used; each has its own benefits, technical challenges, and limitations. In many cases, these noninvasive methods are sufficient for diagnosis and management. However, when they produce unclear findings or more information is needed about the vascular anatomy, angiography is required. In addition, angiography is required as a precursor to endovascular treatments. (See the images below.)

Digital subtraction angiogram demonstrating an acu Digital subtraction angiogram demonstrating an acute L posterior cerebral artery (PCA) occlusion (red arrow) following balloon-assisted coiling of a basilar tip aneurysm.
Digital subtraction angiogram demonstrating revasc Digital subtraction angiogram demonstrating revascularization of acute L posterior cerebral artery (PCA) occlusion (red arrow) during a balloon-assisted basilar tip aneurysm revascularization with use of balloon angioplasty.

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