Transbrachial approach for aortic and selective supraaortic vessel catheterization using a safe and easy technique to...

A total of 286 patients (158 outpatients) were examined by intra-arterial DSA in the evaluation of cerebrovascular disease using a transbrachial approach. In all cases a 5F introducer sheath, a 5F pigtail catheter for aortic arch injection and a 5F Simmons II catheter for selective catheterization were used. Excellent demonstration of aortic arch and supraaortic arteries (including intracranial circulation) was obtained (92.2-100%). The complication rate was favorable, with only one major complication (thrombosis of an axillary artery). The use of an introducer sheath minimizes local complications and vessel wall damage during catheter exchange. Aortic arch injection must always be performed prior to selective catheterization. The results of selective catheterization prove the suitability of the Simmons II catheter, whose typical shape was easily and safely obtained using the configuration of the pigtail catheter and a 180 cm long guide wire for catheter exchange. Using the technique as described, the transbrachial approach is a safe and easy way for optimal vascular evaluation in cerebrovascular disease, especially useful in outpatients.