Feasibility and utility of transradial cerebral angiography: experience during the learning period.
OBJECTIVE
We wanted to present our experiences for performing transradial cerebral angiography during the learning period, and we also wanted to demonstrate this procedure's technical feasibility and utility in various clinical situations.


METHODS
Thirty-two patients were enrolled in the study. All of them had unfavorable situations for performing transfemoral angiography, i.e., IV lines in the bilateral femoral vein, a phobia for groin puncture, decreased blood platelet counts, large hematoma or bruise, atherosclerosis in the bilateral femoral artery and the insistence of patients for choosing another procedure. After confirming the patency of the ulnar artery with a modified Allen's test and a pulse oximeter, the procedure was done using a 21-G micorpuncture set and 5-F Simon II catheters. After angiography, hemostasis was achieved with 1-2 minutes of manual compression and the subsequent application of a hospital-made wrist brace for two hours. The technical feasiblity and procedure-related immediate and delayed complications were evaluated.


RESULTS
The procedure was successful in 30/32 patients (93.8%). Failure occurred in two patients; one patient had hypoplasia of the radial artery and one patient had vasospasm following multiple puncture trials for the radial artery. Transradial cerebral angiography was technically feasible without significant difficulties even though it was tried during the learning period. Pain in the forearm or arm developed in some patients during the procedures, but this was usually mild and transient. Procedure-related immediate complications included severe bruising in one patient and a small hematoma in one patient. Any clinically significant complication or delayed complication such as radial artery occlusion was not demonstrated in our series.


CONCLUSIONS
Transradial cerebral angiography is a useful alternative for the patients who have unfavorable clinical situations or contraindications for performing transfemoral cerebral angiography. For the experienced neurointerventionalists, it seems that additional training for performing transradial cerebral angiography is not needed.
Department of Diagnostic Radiology, Konyang University Hospital, Daejeon, Korea. radol@unitel.co.kr
Ji Hyung
JH
Kim
Yong Sung
YS
Park
Chul Gu
CG
Chung
Kyeong Sug
KS
Park
Dong Jin
DJ
Chung
Hyun Jin
HJ
Kim
D000328:Adult; D000368:Aged; D002404:Catheterization / Q000379:methods*; D002533:Cerebral Angiography / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D020300:Intracranial Hemorrhages / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D017534:Radial Artery; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging