T Rosen1, F Poretti, H Krawczynski, D Vorwerk. 1. Institut für diagnostische und interventionelle Radiologie des Klinikums Ingolstadt. thomas.rosen@Klinikum.ingolstadt.de
Abstract
PURPOSE: To describe safety and efficacy of transbrachial selective carotid digital subtraction angiography (DSA) in outpatients. MATERIALS AND METHODS: From July 1999 to November 2001, selective carotid angiography was performed in 141 outpatients preferably using a left brachial arterial approach. The average age of the patients was 68 years (range: 39 - 89 years). After flush aortography through a 4F-pigtail catheter, bilateral selective common carotid artery (CCA) catheterization was performed with 4F-Sidewinder-1 or Sidewinder-2 catheters. In 49 patients, Doppler-sonography was performed before or after arteriography. A total of 41 patients underwent carotid surgery. RESULTS: Selective catheterization of the CCA was successful in 96 % of the cases. The diagnostic quality of the opacified aorta and CCA images was good to excellent. The overall complication rate did not exceed 2.1 %, and severe complications were not observed. One patient showed transient neurological symptoms and another mild nausea and agitation, probably as toxic reaction to the contrast medium. A single local hematoma developed after unsuccessful puncture of the brachial artery. CONCLUSION: Transbrachial selective carotid DSA is safe, reliable and well-tolerated in outpatients and achieves a superimposition-free CCA visualization.
PURPOSE: To describe safety and efficacy of transbrachial selective carotid digital subtraction angiography (DSA) in outpatients. MATERIALS AND METHODS: From July 1999 to November 2001, selective carotid angiography was performed in 141 outpatients preferably using a left brachial arterial approach. The average age of the patients was 68 years (range: 39 - 89 years). After flush aortography through a 4F-pigtail catheter, bilateral selective common carotid artery (CCA) catheterization was performed with 4F-Sidewinder-1 or Sidewinder-2 catheters. In 49 patients, Doppler-sonography was performed before or after arteriography. A total of 41 patients underwent carotid surgery. RESULTS: Selective catheterization of the CCA was successful in 96 % of the cases. The diagnostic quality of the opacified aorta and CCA images was good to excellent. The overall complication rate did not exceed 2.1 %, and severe complications were not observed. One patient showed transient neurological symptoms and another mild nausea and agitation, probably as toxic reaction to the contrast medium. A single local hematoma developed after unsuccessful puncture of the brachial artery. CONCLUSION: Transbrachial selective carotid DSA is safe, reliable and well-tolerated in outpatients and achieves a superimposition-free CCA visualization.