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Selective catheterization of the brachiocephalic arteries via the right brachial artery
1Department of Radiology, Kyushu Rosai Hospital, Fukuoka, Japan.
Insights
Transbrachial selective angiography is a safe and effective method for visualizing brachiocephalic arteries. This minimally invasive technique offers high success rates for both inpatient and outpatient procedures.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Diagnostic Imaging
Background:
- Selective angiography is crucial for diagnosing cerebrovascular and upper extremity arterial diseases.
- The transbrachial approach offers an alternative access route for brachiocephalic artery imaging.
Purpose of the Study:
- To evaluate the safety, efficacy, and ease of performing selective intra-arterial digital subtraction angiography of the brachiocephalic arteries via the right brachial artery approach.
Main Methods:
- 173 patients underwent selective angiography using 4-F modified Simmons catheters via the right brachial artery.
- Success rates for catheterization of individual brachiocephalic vessels were recorded.
- Procedure time and complications were documented.
Main Results:
- Successful catheterization was achieved in 169 of 173 patients (97.7%).
- High success rates were observed for selective catheterization of common carotid arteries (99.4%), right vertebral artery (84.2%), and left subclavian artery (93.9%).
- Mean examination time for a four-vessel study was 24.3 minutes with no major complications.
Conclusions:
- Transbrachial selective catheterization of brachiocephalic arteries is a safe, effective, and relatively easy procedure.
- This technique is suitable for both inpatient and outpatient settings.
- It provides excellent visualization of the brachiocephalic vasculature.
Abstract:
Selective intra-arterial digital subtraction angiography of the brachiocephalic arteries using the right brachial artery approach was successfully performed for 169 of 173 patients, 33 of whom were outpatients. Catheterization was unsuccessful for four patients; two of them elderly hypertensive men with tortuous brachial arteries, and two of them middle-aged obese women for whom arterial puncture could not be performed. 4-F modified Simmons type catheters were used in this study. Selective catheterizations of both common carotid arteries were successfully performed in all but one patient, a woman whose aberrant right subclavian artery prevented bilateral common carotid arterial catheterizations. Selective catheterizations of the right vertebral and left subclavian arteries, though relatively difficult, were successfully performed in 84.2% and 93.9% of patients, respectively. The mean examination time for a four-vessel study was 24.3 min. No major complications were encountered. Thus, transbrachial selective catheterization of the brachiocephalic arteries proved to be safe, useful, and relatively easy to perform.