Left or right transaxillary approach in lower extremity arteriography for severe occlusive vascular disease. An anatomic study of a roentgenologic problem.

In an anatomic study of 46 specimens, the angle of the brachiocephalic trunk and the left subclavian artery to the tangent of the aortic arch was measured in an effort to decide which route offers the quickest access to the descending aorta in lower extremity angiography for severe occlusive vascular diseases. The study shows that the average angles (77.1 +/- 16.0 degrees for the brachiocephalic trunk/77.7 +/- 16.3 degrees for the left subclavian artery) are not significantly different. Since the right axillary approach incurs other risks that could only be compensated by significantly quicker access, i.e. shorter maneuvering time in the aortic arch we conclude that in patients of all ages the left side should be the access route of choice.