Pediatric diagnostic cerebral angiography: practice recommendations from the SNIS Pediatric Committee

The pediatric population spans a diverse age group,1 from neonates and infants to adult-sized teenagers, each with unique physiological characteristics that must be considered when performing diagnostic cerebral angiography (DCA). Herein we refer patients as under the of 18 years. Neonates will not discussed further due very limited role DCA in absence planned neurointervention, most commonly for vein Galen malformations other high-flow arteriovenous fistulas leading life-threatening heart failure. The number neuroangiography procedures performed continues grow2 it is evident technical aspects are highly variable among practitioners, including our own Task Force members. This reflects diversity angiographers different specialties varying levels prior training experience. In 2019, Society Neurointerventional Surgery (SNIS) surveyed its membership regarding their individual fellowship current practice relates collectively neuroangiography, both interventional procedures. Unpublished results indicate experience across nation (figure 1). Most respondents (94%) during fellowship, though this was mostly low volume. children 4 years age, reduced (40%: 0–10 cases; 45%: 11–49 cases). Despite exposure, 76% reported currently treating patients, more than half (53%), volume remains low: cases per year. Practice guidelines cervicocerebral catheter have been published adults,3 however, no similar recommendations exist children. Given information, Pediatric Committee members SNIS sought provide framework which safe can performed, detailing specific procedural considerations well peri-procedural evaluation …