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Transbrachial arteriography: indications and complications
S D Heenan1, S Grubnic, T M Buckenham
1Department of Radiology, St. George's Healthcare Trust, London, UK.
Clinical Radiology
|March 1, 1996
Summary
Brachial artery puncture in the antecubital fossa is a safe and effective alternative for vascular access, especially when the femoral approach is not feasible. This low-risk method shows minimal complications, making it suitable for diagnostic and interventional procedures.
Area of Science:
- Vascular Access Procedures
- Interventional Cardiology
- Peripheral Arterial Interventions
Background:
- The brachial artery at the antecubital fossa is an alternative access site for vascular procedures.
- Indications include contraindications to femoral access, such as absent pulses or graft surgery.
- It can also serve as a direct route for upper limb arterial assessment.
Purpose of the Study:
- To evaluate the indications and complications of brachial artery puncture at the antecubital fossa.
- To assess the safety and efficacy of this approach for diagnostic and interventional procedures.
Main Methods:
- Retrospective review of 62 brachial artery punctures in 53 patients over 5 years.
- Procedures included diagnostic (82%) and interventional (18%) cases, with catheter sizes from 3F to 8F.
- Routine administration of glyceryl trinitrate was noted.
Main Results:
- The brachial approach was primarily used to avoid groin puncture in specific patient groups.
- Overall complication rate was low (8%), including hematoma and arterial spasm.
- No complications required surgical intervention, and all resolved without permanent issues.
Conclusions:
- Brachial artery puncture at the antecubital fossa is a suitable access site for both diagnostic and interventional vascular procedures.
- Potential limitations include the distance to the intervention site and risk of upper limb ischemia.
- It offers a low-risk alternative to femoral or axillary access when the femoral approach is contraindicated.