Limited usefulness of aortic arch angiography in the evaluation of carotid occlusive disease

The role of aortic arch angiography in the evaluation of cerebral ischemic disease is not well defined. In an attempt to develop guidelines for its optimal use, a prospective study of 100 patients with carotid distribution ischemic events was undertaken. Each patient underwent bilateral selective carotid angiography followed by arch aortography. In only two of the cases did the arch examination affect patient management. In the other individuals, the arch study either added no clinically useful information (69), or demonstrated abnormalities that did not affect patient care (29). The findings of this study support the use of arch aortography only in those patients who have surgical lesions demonstrated by the selective carotid examinations.