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Feasibility and Safety of a Computer-Controlled Device for Transradial Cerebral Angiography: A Prospective Pilot
Shun Tanaka1,2, Koji Hirata1, Koichi Uramaru1
1Department of Stroke and Cerebrovascular Diseases, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan.
Objective:
This study aimed to evaluate the feasibility and safety of a computer-controlled local anesthetic delivery device during transradial cerebral angiography and to descriptively assess procedural pain and hemodynamic changes in an initial series of patients.
Methods:
In this prospective pilot study, 10 consecutive adult patients undergoing elective diagnostic cerebral angiography via the radial artery received local anesthesia with a computer-controlled injection device using 1 mL of 3% mepivacaine delivered through a 33-G needle. The primary outcome of this study was feasibility, defined as successful delivery of local anesthesia and completion of transradial access without device-related complications or the need to convert to manual injection. Secondary outcomes included pain intensity assessed using a 0-100-mm visual analogue scale (VAS) at predefined procedural steps, hemodynamic changes before and after sheath insertion, and access-site adverse events such as vasospasm or bleeding. Blood pressure was compared between baseline (immediately before local anesthesia) and after sheath insertion.
Results:
All 10 procedures were successfully completed using the computer-controlled device without device malfunction, conversion to manual injection, or access failure. The first puncture attempt was successful in all patients. The median VAS score following local anesthesia was 18 [13-22] mm, following arterial puncture was 3 [2-4.75] mm, and following sheath insertion was 7.5 [3-10] mm. There was no significant difference in median systolic blood pressure before local anesthesia and after sheath insertion (160.7 ± 30.6 vs. 160.1 ± 27.6 mmHg; p = 0.84), and diastolic blood pressure also did not change significantly (80.5 ± 6.2 vs. 77.5 ± 10.0 mmHg; p = 0.16). No clinically evident radial artery spasm or hemorrhagic access-site complications occurred.
Conclusion:
In this pilot study, computer-controlled local anesthesia during transradial cerebral angiography was feasible and appeared safe in a small cohort of patients. Pain-related findings should be interpreted as descriptive and hypothesis-generating, and further controlled studies are required to evaluate efficacy.
