Intraoperative Angiography

Abstract

A technique of intraoperative angiography is described. It may provide the operating surgeon with valuable information, and it involves a minimum of special equipment. A catheter is introduced via the superficial temporal artery, without puncture of the common carotid artery or the femoral artery. The equipment required includes a portable X-ray machine, tubing, a syringe, contrast medium, and a pair of simple devices for holding a film cassete against the Sugita head frame. When the surgeon believes that an intraoperative angiography is indicated, the superficial temporal artery, which has been exposed by the scalp incision, is punctured, and a guide wire is introduced. The guide wire is advanced adversely into the common carotid artery. The catheter is then threaded over the guide wire into the common carotid artery. Because of the presence of the catheter in the external carotid artery, the injected contrast medium only fills the internal carotid artery, enabling finer figures to be seen. This technique may be of great value in patients with arteriovenous malformation (AVM), especially if it is deep-seated and there is any question as to a retained part, as well as in verifying the complete removal of an AVM, intraoperatively.