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Procedure Dynamics in Transfemoral vs Transradial Cerebral Angiography: A Retrospective Study
Tae-Sung Kim1, Jinhoo Seok1, Haewon Roh1
1Department of Neurosurgery, Korea University Guro Hospital, Seoul, South Korea.
Insights
Transradial cerebral angiography (TRCA) is a safe alternative to transfemoral cerebral angiography (TFCA) for diagnosing neurovascular diseases. Procedure times and radiation exposure are comparable, with TRCA offering improved patient comfort and recovery.
Area of Science:
- Neurology
- Vascular Surgery
- Radiology
Background:
- Cerebral angiography is crucial for diagnosing neurovascular diseases.
- Transfemoral cerebral angiography (TFCA) is conventional, but transradial cerebral angiography (TRCA) offers potential benefits like reduced complications.
- Procedure times and influencing factors for TRCA versus TFCA require further investigation.
Purpose of the Study:
- To compare procedure times between TFCA and TRCA.
- To identify factors influencing prolonged procedure times in cerebral angiography.
- To evaluate TRCA as an alternative to TFCA for diagnostic neurovascular imaging.
Main Methods:
- Retrospective analysis of 193 patients undergoing 4-vessel cerebral angiography (100 TFCA, 93 TRCA).
- Comparison of procedure times, puncture times, and radiation exposure between TFCA and TRCA groups.
- Logistic regression analysis to determine factors associated with prolonged procedures (>20 minutes).
Main Results:
- Procedure times were similar between TFCA (median 20.00 min) and TRCA (median 24.50 min), p=0.139.
- Radiation exposure was comparable (TFCA: 421.00 mGy vs TRCA: 418.50 mGy), p=0.530.
- Hypertension (OR: 2.255) and aortic arch tortuosity (OR: 3.881) were significant predictors of prolonged procedures.
Conclusions:
- Transradial cerebral angiography (TRCA) is a safe and effective alternative to TFCA.
- TRCA demonstrates comparable procedure times and radiation exposure to TFCA.
- Patient factors like hypertension and aortic arch tortuosity impact procedure duration, but TRCA offers advantages in patient comfort and recovery, supporting its wider use.
Abstract:
BACKGROUND Cerebral angiography, although invasive, remains the most accurate diagnostic tool for neurovascular diseases. While transfemoral cerebral angiography (TFCA) is the conventional approach, transradial cerebral angiography (TRCA) has gained interest due to potential benefits, such as reduced hematoma risk and shorter recovery times. However, procedure times and influencing factors remain debated. This retrospective study from a single center aimed to compare procedure time in 100 patients undergoing conventional TFCA and 93 undergoing TRCA. MATERIAL AND METHODS This single-center retrospective study included 193 patients who underwent 4-vessel cerebral angiography from January to December 2023. TFCA and TRCA were performed by experienced neurosurgeons. TRCA involved radial artery access with collateral circulation assessment (modified Allen's and Barbeau's tests), and TFCA used femoral artery access with standard techniques. Clinical data, including puncture times and radiation exposure, were collected. Logistic regression identified factors influencing prolonged procedure times (>20 minutes). RESULTS Procedure times for TFCA and TRCA were similar (median: 20.00 minutes vs 24.50 minutes, p=0.139), though TRCA showed longer puncture times (median: 10.00 vs 10.00 minutes, p=0.001). Radiation exposure was comparable (421.00 milliGray (mGy) vs 418.50 mGy, p=0.530). Hypertension (OR: 2.255, p=0.011) and aortic arch tortuosity (OR: 3.881, p=0.002) significantly influenced prolonged procedures. CONCLUSIONS TRCA offers a safe and effective alternative to TFCA for diagnostic cerebral angiography, with comparable procedure times and radiation exposure. While patient-specific factors, such as hypertension and aortic arch tortuosity, influence procedure duration, TRCA provides benefits in patient comfort and recovery. These findings support the broader use of TRCA in diagnostic settings.
