Femoral-cerebral angiography in infants and children. Analysis and comparison with direct puncture/retrograde brachial technique.

The technique of femoral-cerebral catheterization in infants and children is described, and a series of 1,869 procedures is analyzed for complications. Clinical complications occurred in 12 of 678 or 1.8% of examinations while radiographic complications were discovered in 38 of 1,869 or 1.1% of procedures. The results are compared to a similar retrospective study of a large series (2,184 procedures) of direct puncture/retrograde brachial studies in a similar patient population at the same institution in which there was a 2.6% clinical complication rate and a 4.3% radiographic complication rate. Those factors which predispose to complications, clinical or radiographic, are more pronounced in the younger age groups but affect the direct puncture/retrograde brachial technique to a greater degree. The lower morbidity, greater selectivity and improved comfort make the femoral-cerebral route preferable for neuroangiographic studies in infants and children.