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Published on: January 31, 2017
Reflected-wire technique for internal carotid artery catheterisation via the left radial approach in cerebral
Sheth Rishabh Hitendra1, Vikas Bhatia1, Ajay Kumar1
1Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Background:
The aim of this study was to evaluate factors causing difficulty in internal carotid artery (ICA) access using the left transradial approach for diagnostic cerebral angiography.
Methods:
This was a prospective, single-centre, analytical study (n = 32 enrolled, n = 31 analysed) with an indication for diagnostic cerebral angiography. Diagnostic angiography via left transradial access was performed in all cases. Factors influencing the bilateral ICA catheterisation were evaluated.
Results:
Diagnostic angiography was successfully completed in all 31 analysed patients (100%). Successful RICA catheterisation was observed in 25 (80.6%) cases, and LICA catheterisation was observed in 77.43% (24/31) of cases. Reflecting the hydrophilic guidewire off the aortic root/valve to gain support and advance the catheter into the ICA was required in 17/24 (70.8%) of LICA and 9/25 (36%) of RICA cases to facilitate catheterisation. Positive correlation was observed between BCA-LCCA, left CCA-left subclavian artery angles and inability to cannulate LICA. A Type III arch was associated with an increased LICA cannulation time. The presence of a bovine aortic arch necessitated the use of the reflected-wire technique to cannulate the LICA.
Conclusions:
The reflected-wire technique can be used to facilitate ICA catheterisation via the left radial approach.
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