Intraoperative carotid arteriography. A comparison of two techniques

Routine intraoperative completion carotid arteriography was performed in 225 patients from January 1980 to December 1985 to detect technical problems. In the first 100 patients, standard common carotid artery puncture was used. In the last 125 patients, catheter technique through the superior thyroid artery was compared with the needle technique to evaluate quality of images, completeness of the study, number of exposures required, and complications from these two techniques. The needle technique resulted in complete visualization of the extracranial and intracranial circulations in 94 patients (94 percent). The catheter technique was similarly successful in 123 of 125 patients (98 percent). The proportions of complete visualization were not statistically different in the two groups (p = 0.16). Six patients (6 percent) in the needle technique group and three patients (2 percent) in the catheter technique group required multiple exposures. When the complications incurred by the two techniques were compared, there was no statistical difference between the two techniques (p = 0.39). Two complications occurred in the needle technique group (2 percent), one resulting in dissection and the other, extravasation. There were no complications in the catheter technique group. Due to technical ease of performance, the catheter technique is preferred, although statistical data did not reveal superiority of one technique over the other.