J Neurosurg Pediatr. 2025 Jul 11:1-7. doi: 10.3171/2025.3.PEDS24406. Online ahead of print.
ABSTRACT
OBJECTIVE: The aim of this study was to compare the efficacy and safety of diagnostic cerebral angiography in children under local anesthesia (LA) versus general anesthesia (GA).
METHODS: This retrospective cohort study included children who underwent diagnostic cerebral angiography between September 2018 and September 2021. Medical records were reviewed to identify eligible patients and assign them to the LA or GA group. Baseline demographics, procedural metrics, medical expenses, image quality, pain scores, vital signs (mean arterial pressure and partial oxygen pressure), and complications were compared between the groups.
RESULTS: In total, 128 children (mean age 10.38 ± 2.28 years; 56 [43.8%] males) underwent diagnostic cerebral angiography. The LA and GA groups comprised 40 and 88 children, respectively. No significant differences were observed in baseline characteristics, contrast agent volume, fluoroscopy time, radiation exposure, scanning duration, image vascular contrast and integrity, diagnostic efficacy, length of hospital stay, and pain scores between the groups (p > 0.05). Although the LA group had significantly shorter anesthesia duration, postanesthesia care unit stay, and lower medical expenses, this group exhibited more motion artifacts and poorer image clarity compared with the GA group (p < 0.05). In addition, the mean arterial pressure decreased in both groups during the procedure. Complications included inguinal hematoma in both groups, whereas skin rash, headache, and vomiting occurred only in the general anesthesia group.
CONCLUSIONS: Diagnostic cerebral angiography under LA can safely be used to obtain images with comparable visualization of vascular contrast and integrity and diagnostic yield to those obtained under general anesthesia. Notably, local anesthesia offers the advantages of shorter anesthesia duration and reduced healthcare costs.
PMID:40644716 | DOI:10.3171/2025.3.PEDS24406
