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Published on: June 3, 2021
Complications Following Transradial Cerebral Angiography : An Ultrasound Follow-Up Study
Wonki Yoon1, Woo-Keun Kwon1,2, Omar Choudhri3
1Department of Neurosurgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
Insights
Transradial cerebral angiography (TRCA) is generally safe, with Doppler ultrasonography (DUS) showing minimal radial artery (RA) diameter changes and few complications. Smaller pre-procedure RA diameter was linked to abnormal findings, but overall, TRCA appears acceptable.
Area of Science:
- Vascular Medicine
- Interventional Cardiology
- Neuroradiology
Background:
- Transradial catheterization is established for coronary and neuro-interventions.
- The anatomical impact on the radial artery (RA) post-transradial cerebral angiography (TRCA) requires further understanding.
Purpose of the Study:
- To evaluate the feasibility and safety of transradial catheterization for neuro-intervention.
- To assess anatomical changes in the radial artery (RA) after routine transradial cerebral angiography (TRCA) using ultrasonography.
Main Methods:
- Retrospective review of 223 transradial cerebral angiographies (TRCAs) in 181 patients.
- Pre- and post-procedure Doppler ultrasonography (DUS) of the radial artery (RA) to record diameter and complications.
- Analysis of factors associated with RA diameter changes and complications.
Main Results:
- Mean RA diameter was 2.48 mm, correlated with male gender and hypertension.
- Median RA diameter change post-TRCA was minimal (<0.1 mm), with 90% within -0.8 to +0.7 mm.
- 12 cases (5.3%) of intimal hyperplasia and 22 (9.6%) asymptomatic local vascular complications were observed via DUS. Smaller pre-procedural RA diameter was associated with abnormal findings (p=0.0028).
Conclusions:
- Doppler ultrasonography effectively identifies pre- and post-procedural radial artery (RA) diameter and local complications.
- Routine transradial cerebral angiography (TRCA) demonstrates acceptable safety regarding local complications and RA diameter changes.
Objective:
The feasibility and usefulness of transradial catheterization for coronary and neuro-intervention are well known. However, the anatomical change in the catheterized radial artery (RA) is not well understood. Herein, we present the results of ultrasonographic observation of the RA after routine transradial cerebral angiography (TRCA).
Methods:
Patients who underwent routine TRCA with pre- and post-procedure Doppler ultrasonography (DUS) of the catheterized RA were enrolled. We then recorded and retrospectively reviewed the diameter and any complicated features of the RA observed on DUS, and the factors associated with the diameter and complications were analyzed.
Results:
A total of 223 TRCAs across 181 patients were enrolled in the current study. The mean RA diameter was 2.48 mm and was positively correlated with male gender (p<0.001) and hypertension (p<0.002). The median change in diameter after TRCA was less than 0.1 mm (range, -1.3 to 1.2 mm) and 90% of changes were between -0.8 and +0.7 mm. Across 228 procedures, there were 12 cases (5.3%) of intimal hyperplasia and 22 cases (9.6%) of asymptomatic local vascular complications found on DUS. Patients with abnormal findings on the first procedure had a smaller pre-procedural RA diameter than that of patients without findings (2.26 vs. 2.53 mm, p=0.0028). There was no significant difference in the incidence of abnormal findings for the first versus subsequent procedures (p=0.68).
Conclusion:
DUS identified the pre- and post-procedural diameter and local complications of RA. Routine TRCA seems to be acceptable with regard to identifying local complications and changes in RA diameter.
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