Cerebrovascular disease: outpatient evaluation with selective carotid DSA performed via a transbrachial approach

A total of 355 outpatients and 73 inpatients were studied for cerebrovascular disease with intraarterial digital subtraction angiography (DSA). The studies were performed by means of selective carotid and vertebral artery catheterization from a transbrachial approach. Selective catheterization of the carotid artery was possible in 95% of patients, with definitive examinations of both extra- and intracranial circulation obtained in 95%-100% of all patients. Vessel opacification was very good to excellent, and the technique was inherently free from artifact caused by vessel overlap or involuntary motion. There were 25 complications, of which 20 were local in nature. Iodine load per case was extremely low, averaging 4.2-7.0 g. Selective carotid and vertebral catheterizations by the brachial route proved to be as safe as intravenous DSA and aortic arch intraarterial DSA with less contrast material load and superior images.