Improved Fluoroscopy and Time Efficiency with Radial Access for Diagnostic Cerebral Angiography

Radial artery catheterization has been newly incorporated into the field of endovascular surgical neuroradiology as a safer and more efficient method for Cerebral angiography as opposed to the femoral artery approach. The objective is to understand the relationship between cerebral angiography procedure times after an operator has converted to a radial first approach.

A retrospective analysis was conducted from January to August of 2019 to compare procedural times for femoral and radial artery approaches. This was conducted by comparing different procedural specifications, such as total procedural time, fluoroscopy time, and amount of contrast used.

The average age of the 434 patients in the analysis was 63.9 years with a range of 19 and 96 years. One hundred eighty-three patients (mean fluoroscopy time 7.55, 95% confidence interval 7.03-8.08) underwent successful diagnostic cerebral angiographies through the radial artery and, 251 patients through the femoral approach. The first 2 months of the radial approach saw an average fluoroscopy time of 11.23 minutes. In the last 2 months of the study, the fluoroscopy time plateaued to an average of 6.73 minutes after 55 cases. Radial artery average procedural time was reduced from 33 to 21 minutes. Angiography utilizing the femoral approach averaged 16 minutes throughout the study period.

Transradial procedural time and fluoroscopy time continued to improve until about 55 cases, but did not reach the peak efficiency of the femoral approach. Further advances in catheter technology are needed to continue to improve radial artery diagnostic cerebral angiography.