- Catheter spinal angiography remains the gold standard for the assessment of structural vascular pathology.
- Sequential catheterization of each segmental arterial supply to the cord together with examination of the circle of Willis and medial sacral arteries is required.
- Access is usually via the femoral arteries, but brachial access may facilitate examination of the thoracic and cervical segments in the presence of severe aortoiliac disease.
- GA
- Long imaging period
- Comfort for patient
- Physiological movement (e.g. respiration and peristalsis) may degrade imaging and are more easily controlled under general anaesthesia.
- Staging of the examination also allows the radiation exposure to be fractionated and the contrast load aliquoted.
- MR spinal angiography or CT angiography is utilized to allow targeting of catheter spinal angiography
- Complication
- Neurological complications
- Rare in experienced hands despite its technically demanding nature and that it is carried out far less frequently than cerebral angiography
- Non- neurological complications that have been described included
- Vascular injury,
- Retroperitoneal haematoma,
- Pulmonary oedema,
- Contrast sensitivity
- The intrinsic vessels of the cord are usually straightforward to distinguish on angiography.
- The veins are characteristically sinusoidal and centrally located while the arteries are straighter and the radiculomedullary vessels terminate in a characteristic ‘hair- pin’ morphology.
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