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Brachiocephalic vessels in the elderly: technique for catheterization
M W Mewissen1, W R Zavitz, E O Lipchik
1Department of Radiology, Veterans Administration Medical Center, Milwaukee, WI 53295.
Insights
Selective catheterization in elderly patients is challenging due to aortic changes. A specialized guide wire enabled safe femorocerebral angiography in most elderly patients, ensuring patent left subclavian arteries.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Geriatric Medicine
Background:
- Selective catheterization and angiography of brachiocephalic vessels present challenges in elderly patients.
- Aortic tortuosity and unfolding in older individuals complicate these procedures.
Purpose of the Study:
- To evaluate the efficacy of a specialized guide wire for safe femorocerebral angiography in the elderly.
- To assess the success rate and safety of using the Simmons sidewinder catheter in this patient population.
Main Methods:
- The study involved selective catheterization and angiography of brachiocephalic vessels in elderly patients.
- A special guide wire was utilized in conjunction with the Simmons sidewinder catheter.
- Femorocerebral angiography was performed in 48 elderly patients.
Main Results:
- The specialized guide wire facilitated successful and safe femorocerebral angiography in 47 out of 48 elderly patients.
- All 47 patients who underwent successful angiography had a patent left subclavian artery.
- The technique proved effective despite pre-existing aortic tortuosity and unfolding.
Conclusions:
- A specialized guide wire significantly improves the success and safety of femorocerebral angiography in elderly patients.
- The Simmons sidewinder catheter, with this guide wire, is a valuable tool for navigating complex aortic anatomy in older adults.
- The procedure ensures the patency of critical arteries like the left subclavian artery.
Abstract:
Selective catheterization and angiography of brachiocephalic vessels in the elderly may be difficult because of tortuosity and unfolding of the thoracic aorta. Use of a special guide wire contributed to the successful performance of safe femorocerebral angiography with the Simmons sidewinder catheter in the 47 of 48 elderly patients in whom it was performed. All 47 had patent left subclavian arteries.