
A comprehensive analysis of 5152 brain death examinations over four years evaluated the implementation and impact of computed tomography angiography (CTA) as a confirmatory study. CTA, introduced in the German brain death guideline in 2015, demonstrated a steady rise in usage, from 17.2% to 29.7%. It replaced other confirmatory studies without increasing their frequency, with a low technical failure rate (0.9%) and 89.3% positive outcomes. Negative results correlated with secondary brain injury or prolonged clinical brain death syndrome. CTA, though lengthening diagnosis time, proved effective within the specified guideline context.
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