The informed consent form of routine cerebral angiography surgery is uploaded for your reference. Operation purpose:

Some patients with cerebrovascular diseases have vascular malformations, aneurysms or other vascular abnormalities; According to the diagnosis of vascular stenosis, occlusion, large and small artery dissection inside and outside the brain, and the analysis and evaluation of collateral circulation of vascular stenosis, the next treatment is guided. Surgical risk

Explain the possible complications and surgical risks during or after operation to patients or relatives. Some uncommon risks may not be listed here, and the specific surgical procedures vary according to the situation of different patients:

1) allergic reaction: drugs used in surgery (contrast agent, anesthetic, etc.). ) may cause skin allergy, dyspnea, anaphylactic shock, hemolytic reaction, etc.

2) Complications at puncture site: unsuccessful puncture, local hematoma, pseudoaneurysm or arteriovenous fistula formation, and damage to adjacent organs.

3) Complications related to selective intubation: vasospasm, intimal injury, arterial dissection or vascular rupture; Thrombosis, mural thrombus or plaque shedding cause ischemia and necrosis of corresponding blood supply tissues and organs. Cerebral vascular thromboembolism (mostly caused by plaque in internal carotid artery or embolus falling off in heart).

4) Toxic and side effects caused by contrast agent: allergic reaction, gastrointestinal reaction, bone marrow suppression, liver and kidney function damage, skin mucosal ulcer, etc.

5) Infection (including local and systemic).

6) The operation is unsuccessful due to abnormal anatomical structure, or it needs to be operated by stages.

7) Intracranial hemorrhage (including arterial or venous hemorrhage) and puncture local hematoma.

8) In the operating room, the illness worsened and death occurred;

9) Aneurysm rupture during or after operation leads to paralysis or death; Intracranial hemorrhage caused by anticoagulant therapy, and cerebral infarction or death caused by vascular compression after bleeding;

10) catheter is broken and knotted.

1 1) Retroperitoneal hematoma caused by operation may be life-threatening.

12) Radiation may cause harm.

13) Angiography found no lesions, and it may be necessary to check again at another time.

14) Some materials shall be paid at their own expense.

15) In addition to the above situations, other complications that may occur in this medical measure or other matters that need special attention from patients and their families.