Feasibility and safety of transradial artery approach for selective cerebral angiography.
The transradial artery (TRA) approach is a conventional means of diagnostic cardiac catheterization and catheter-based coronary intervention. However, to our knowledge, the safety and feasibility of cerebrovascular angiographic studies using the TRA approach for patients with brain ischemia has not been reported. This study investigated whether the TRA approach using 6 Fr Kimny guiding catheter for both extracranial and intracranial angiographies is safe and effective for patients with a history of stroke, transient ischemic attack, or significant carotid stenosis. From February 2003 to June 2004, a total of 46 consecutive patients with an age range from 50 to 83 years were enrolled into the study. The retrograde engagement technique that involved lopping the guiding catheter was utilized. Outpatient carotid angiography was performed in 40% of the study patients. The overall procedural success (defined as completely evaluating both carotid and vertebral arteries and intracranial vessels) was 93.5% (n = 43) using the Kimny guiding catheter. Significant cerebrovascular stenosis (> 50%), including carotid artery in 52.2% (n = 24), vertebral artery in 15.2% (n = 7), and intracranial major artery in 15.2% (n = 7), was found in 82.6% of the patients. Notably, 17 (37.0%) of these patients with severe carotid stenosis (> or = 70%) required staged carotid stenting. Concomitant vertebral artery stenting was performed in four (8.7%) patients because of severe stenosis (> or = 70%) of these vessels. Two patients experienced transient dizziness (duration < 30 min) following the procedure. TRA approach for selective cerebral angiography is safe and feasible in patients with a history of brain ischemia.
Wu
Chiung-Jen
CJ
Division of Cardiology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Hung
Wei-Chin
WC
Chen
Shyh-Ming
SM
Yang
Cheng-Hsu
CH
Chen
Chien-Jen
CJ
Cheng
Cheng-I
CI
Chen
Yen-Hsun
YH
Yip
Hon-Kan
HK
D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000628:therapy; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000473:pathology; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000628:therapy; D002406:Catheterization, Peripheral; D002533:Cerebral Angiography / Q000009:adverse effects / Q000379:methods* / Q000592:standards; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000628:therapy; D004244:Dizziness / Q000209:etiology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000000981:diagnostic imaging / Q000628:therapy; D008297:Male; D008875:Middle Aged; D017534:Radial Artery / Q000000981:diagnostic imaging* / Q000473:pathology; D015203:Reproducibility of Results; D020521:Stroke / Q000000981:diagnostic imaging / Q000628:therapy