Alison M Nohara1, David F Kallmes. 1. Department of Radiology, University of Virginia Health Services, Charlottesville, VA, USA.
Abstract
BACKGROUND AND PURPOSE: The transradial approach is routinely used for coronary angiography, but only limited data exist regarding transradial cerebral angiography. The purpose of this report was to offer detailed procedural methods for transradial cerebral angiography to facilitate adoption of the technique. METHODS: We reviewed 60 consecutive cases of transradial access used for neuroangiography and catalogued the indications for angiography, the sheath size, the catheter type, the length of the procedure, the number of cases in which radial artery access was unsuccessful, and the complications. We also noted procedural details regarding adjunctive medications, preprocedural patient assessment, and postprocedural care. RESULTS: Transradial angiography was successfully applied in 57 of 60 cases (51 diagnostic, six interventional, three failed accesses). Sheaths were used in all cases and ranged in size from 4F to 6F. Mean procedural time for diagnostic cases was 40 minutes +/- 19 [SD]. Access-site complications included one forearm hematoma. CONCLUSION: Transradial angiography is a useful tool for diagnostic and interventional neuroangiographic procedures. All relevant vessels can be accessed from the radial artery for diagnostic studies. Interventions in the right vertebral and carotid systems are facilitated by the transradial approach.
BACKGROUND AND PURPOSE: The transradial approach is routinely used for coronary angiography, but only limited data exist regarding transradial cerebral angiography. The purpose of this report was to offer detailed procedural methods for transradial cerebral angiography to facilitate adoption of the technique. METHODS: We reviewed 60 consecutive cases of transradial access used for neuroangiography and catalogued the indications for angiography, the sheath size, the catheter type, the length of the procedure, the number of cases in which radial artery access was unsuccessful, and the complications. We also noted procedural details regarding adjunctive medications, preprocedural patient assessment, and postprocedural care. RESULTS: Transradial angiography was successfully applied in 57 of 60 cases (51 diagnostic, six interventional, three failed accesses). Sheaths were used in all cases and ranged in size from 4F to 6F. Mean procedural time for diagnostic cases was 40 minutes +/- 19 [SD]. Access-site complications included one forearm hematoma. CONCLUSION: Transradial angiography is a useful tool for diagnostic and interventional neuroangiographic procedures. All relevant vessels can be accessed from the radial artery for diagnostic studies. Interventions in the right vertebral and carotid systems are facilitated by the transradial approach.
Authors: Elad I Levy; Alan S Boulos; Richard D Fessler; Bernard R Bendok; Andrew J Ringer; Stanley H Kim; Adnan I Qureshi; Lee R Guterman; L Nelson Hopkins Journal: Neurosurgery Date: 2002-08 Impact factor: 4.654