Intraoperative cerebral angiography: superficial temporal artery method and results.
OBJECTIVE
To report the method for and results of intraoperative cerebral angiography performed via the superficial temporal artery, for assessment of cerebral aneurysm surgery.


METHODS
All patients undergoing craniotomies for treatment of intracranial aneurysms were prospectively entered into a database. A policy of performing angiography via the superficial temporal artery in appropriate cases was instituted. This procedure was performed with retrograde catheterization of the superficial temporal artery, as it coursed over the zygomatic arch, with an 18-gauge, 1.88-inch, intravenous catheter and hand injection of contrast material, with intraoperative digital subtraction fluoroscopic guidance.


RESULTS
Thirty-six patients who underwent 38 craniotomies for clipping of 43 aneurysms underwent intraoperative angiography via the superficial temporal artery. There were six unexpected findings (14%), including four unexpected arterial occlusions and two unexpected residual aneurysms. One aneurysm was observed to be patent when it was punctured, after intraoperative angiography had indicated no filling of the aneurysm. Additional clips were placed. Three patients (8%) developed multiple arterial infarctions in the territory of the injected carotid artery, for which multiple causes were possible. Adequate angiographic images could usually be obtained with this method.


CONCLUSIONS
Intraoperative angiography via the superficial temporal artery is simple and is not associated with substantial complications. It is a reasonable alternative to transfemoral angiography for detection of adverse consequences of intracranial aneurysm clipping.
Department of Surgery, Pritzker School of Medicine and the University of Chicago Medical Center, Chicago, Illinois 60637, USA.
Max C
MC
Lee
R Loch
RL
Macdonald
D015901:Angiography, Digital Subtraction / Q000379:methods*; D002533:Cerebral Angiography / Q000379:methods*; D003399:Craniotomy; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000601:surgery; D007430:Intraoperative Care / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013699:Temporal Arteries / Q000000981:diagnostic imaging*; D016896:Treatment Outcome