Transradial Cerebral Angiography: Technique and Indications

Abstract

Transradial angiography is a useful tool for diagnostic and interventional neuroangiographic procedures. It is routinely used for coronary angiography but there are few reports on the technique in neuroradiolocgical literature. Between April 2004 and February 2005 we enrolled 67 patients for transradial selective cerebral catheterization. We performed 56 diagnostic procedures, four interventional and seven failed accesses. Sheaths were used in all cases ranging in size from 4F to 6F. Standard shape angled Berenstein and Simmons (I, II) 4F catheters were used for three- and four-vessel diagnostic arteriography and 40° 5F and 6F guide catheters for interventional procedures (two external carotid, one vertebral embolization and one left cervical ICA stenting). Periprocedural complications included failure to access the radial/brachial artery (five patients), and transient radial artery spasm with pain (two patients). There were no major complications and/or deficits related to cannulation of the radial artery. Compared with transfemoral and transbrachial approaches, transradial access is a less invasive and safer technique for neuroangiography. Anticoagulant or antiplatelet therapy need not be discontinued for this method. All major vessels can be accessed for diagnostic studies and interventions in the vertebral system and in selected conditions of carotid anatomy are facilitated.