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The transradial approach for selective carotid and vertebral angiography
S Iwasaki1, K Yokoyama, K Takayama
1Department of Radiology, Higashiosaka City General Hospital, Osaka, Japan.
Insights
The transradial approach offers a safe and effective method for cerebral angiography, achieving a 99% success rate with minimal complications. This technique is faster than the traditional femoral approach for carotid and vertebral studies.
Area of Science:
- Vascular Surgery
- Neurology
- Radiology
Background:
- Cerebral angiography is crucial for diagnosing cerebrovascular diseases.
- The transradial approach is less commonly used for cerebral angiography compared to other methods.
- Evaluating the efficacy and safety of the transradial approach is important for expanding its clinical application.
Purpose of the Study:
- To assess the success rate and safety of the transradial approach in cerebral angiography.
- To present the authors' experience with this technique.
Main Methods:
- 526 carotid and vertebral angiographies were performed using the transradial approach.
- Digital subtraction angiography (DSA) was utilized.
- Success was defined by obtaining adequate images for diagnosis.
- Complications were monitored until the following morning.
- Procedure time was measured in a subset of cases.
Main Results:
- The transradial approach demonstrated a high success rate of 99.0% (521 out of 526 cases).
- No severe complications, including neurological events, were reported.
- Minor complications occurred in 3.2% of cases (17 patients), such as ulnar artery thrombus, radial artery angiospasm, and puncture site hematoma.
- The transradial approach was faster than the femoral approach for common and internal carotid studies.
Conclusions:
- The transradial approach is a safe and effective technique for selective carotid and vertebral angiography.
- It offers a high success rate and a low incidence of complications.
- This method provides a valuable alternative for cerebral angiography procedures.
Purpose:
The transradial approach is not so popular in cerebral angiography. The purpose of this study was therefore to present our experience of success rate and safety of this method.
Material And Methods:
From December 1998 to June 2001, 526 carotid and vertebral angiographies with DSA were performed via the radial artery. A 1.4-mm catheter was used through a 1.4-mm introducer sheath. We evaluated the procedure as successful if sufficient images for diagnosis were obtained of the bilateral carotid arteries and unilateral vertebral artery. Each patient was reassessed for any complications, occurring until the next morning. The length of time needed for an examination was measured in the last 10 cases.
Results:
In all but 5 cases, the procedures were evaluated as successful (99.0%). Unsuccessful cases manifested severe pain at the radial puncture, angiospasm at the radial artery, loop formation at the radial artery, occlusion at the subclavian artery, and an aberrant right subclavian artery. No severe complications including neurological ones were encountered. Minor complications were noted in 17 cases (3.2%): 4 cases of thrombus at the ulnar artery, 1 angiospasm at the radial artery, and 12 cases of small hematoma at the puncture site. The radial approach took 14 min less in the common carotid study and 3 min 30 s less in the internal carotid study than by the femoral approach.
Conclusion:
The transradial approach enabled selective studies for carotid and vertebral angiography with a high success rate and safety with few complications.
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