Transient cortical blindness after diagnostic cerebral angiography - A single center report

Background: Transient cortical blindness (TCB) has been reported as a complication after diagnostic cerebral angiography in 0.3 -1% of cases. Our aim was to observe the frequency of TCB after diagnostic cerebral angiography over a period of 11 years using only hypo-osmolar, nonionic contrast agents and following a protocol to reduce both the total volume of injected contrast agent and the number of angiography series obtained. Methods: We retrospectively included all 2431 patients who received diagnostic cerebral angiographies at our institution. Primary outcome measure was the occurrence of TCB after diagnostic cerebral angiography, hypothesizing that the occurrence of TBC depends on the volume of contrast agent and angiography of the vertebrobasilary arteries. Results: Over the analyzed time period of 11 years, we did not observe a single case of TCB following diagnostic cerebral angiography. The median contrast volume used was 100 ml (IQR, 100 -200), ranging from 15 ml to 500 ml. In our cohort, 61.5% of patients received a selective catheterization of the vertebrobasilary territory. In 99.8% of angiographies iopamidol was used a contrast agent. Conclusion: Our results indicate that following to certain aspects of the angiography protocol (using the hypoosmolar, non-ionic contrast agent iopamidol and reducing the number of catheterized vessels and angiography series to a diagnostic minimum) the frequency of transient cortical blindness as a complication of diagnostic cerebral angiography considerably can be very low.