What is the role of angiography in the diagnosis of vertebrobasilar stroke?

Updated: Mar 03, 2020
  • Author: Vladimir Kaye, MD; Chief Editor: Stephen Kishner, MD, MHA  more...
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Answer

Answer

While the role of cerebral (catheter) angiography has changed due to the availability of noninvasive imaging modalities (eg, MRI, MRA, TCD), it still is considered the criterion standard for imaging. Catheter cerebral angiography is performed in the following circumstances:

  • The patient has an absolute contraindication to MRA (eg, a pacemaker, metallic implant)

  • The quality of noninvasive studies is not satisfactory

  • The results of noninvasive studies do not explain the clinical findings

Angiography should be considered a first-line diagnostic test after a CT scan, once it has been decided that recanalization with thrombolysis should be completed. The most important goal of the workup is to establish the type of vascular lesion and the mechanism of the stroke.


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