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Efficacy of Transradial Cerebral Angiography in the Elderly

  • Park, Jung-Hyun (Department of Neurosurgery, Gospel Hospital, Kosin University College of Medicine) ;
  • Kim, Dae-Yong (Department of Neurosurgery, Gospel Hospital, Kosin University College of Medicine) ;
  • Kim, Jin-Wook (Department of Neurosurgery, Gospel Hospital, Kosin University College of Medicine) ;
  • Park, Yong-Seok (Department of Neurosurgery, Gospel Hospital, Kosin University College of Medicine) ;
  • Seung, Won-Bae (Department of Neurosurgery, Gospel Hospital, Kosin University College of Medicine)
  • Received : 2012.08.29
  • Accepted : 2013.04.08
  • Published : 2013.04.28

Abstract

Objective : Transradial angiography has become popular among many cardiologists as a diagnostic and therapeutic tool. However, transradial cerebral angiography is not utilized to the same extent. The purpose of this study is to present our experience regarding the usefulness of transradial cerebral angiography, especially in elderly patients. Methods : Between May 2011 and February 2012, a total of 126 cerebral angiographies were performed via a transradial approach in a single center. Of them, only 47 patients were over 60 years old. In our institution, we shifted the initial access from the right femoral artery to the right radial artery in all patients requiring cerebral angiography in 2011. We did not attempt radial access in 40 cases for variable reasons. Results : The procedural success rate was 92.2%. We have four failures of transradial angiography; two because of loop formations of the radial and brachial artery and two due to multiple puncture failures. All supra-aortic vessels were successfully catheterized. However, the selective catheterization rates of the left side distal vessels were lower, as success rates were 89.7% for the right internal carotid artery and 75% for the left internal carotid artery. Procedure-related vascular complications, such as puncture site hematoma, hand ischemia, pseudoaneurysm, arteriovenous fistula and arterial dissection were not observed in our series. However, intraprocedural thrombosis developed in one patient, which was resolved completely by intraarterial thrombolytic agents. Conclusion : With advancing patient's age, we believe that transradial cerebral angiography is a useful tool to decrease patient's discomfort and more effectively manage the vessel tortuosity.

Keywords

References

  1. Bendok BR, Przybylo JH, Parkinson R, Hu Y, Awad IA, Batjer HH : Neuroendovascular interventions for intracranial posterior circulation disease via the transradial approach : technical case report. Neurosurgery 56 : E626; discussion E626, 2005 https://doi.org/10.1227/01.NEU.0000154820.28342.38
  2. Campeau L : Percutaneous radial artery approach for coronary angiography. Cathet Cardiovasc Diagn 16 : 3-7, 1989 https://doi.org/10.1002/ccd.1810160103
  3. Fessler RD, Wakhloo AK, Lanzino G, Guterman LR, Hopkins LN : Transradial approach for vertebral artery stenting : technical case report. Neurosurgery 46 : 1524-1527; discussion 1527-1528, 2000 https://doi.org/10.1097/00006123-200006000-00044
  4. Heiserman JE, Dean BL, Hodak JA, Flom RA, Bird CR, Drayer BP, et al. : Neurologic complications of cerebral angiography. AJNR Am J Neuroradiol 15 : 1401-1407; discussion 1408-1411, 1994
  5. Hildick-Smith DJ, Walsh JT, Lowe MD, Shapiro LM, Petch MC : Transradial coronary angiography in patients with contraindications to the femoral approach : an analysis of 500 cases. Catheter Cardiovasc Interv 61 : 60-66, 2004 https://doi.org/10.1002/ccd.10708
  6. Iwasaki S, Yokoyama K, Takayama K, Ueda K, Sueyosi S, Nagasawa M, et al. : The transradial approach for selective carotid and vertebral angiography. Acta Radiol 43 : 549-555, 2002 https://doi.org/10.1034/j.1600-0455.2002.430601.x
  7. Jo KW, Park SM, Kim SD, Kim SR, Baik MW, Kim YW : Is Transradial Cerebral Angiography Feasible and Safe? A Single Center's Experience. J Korean Neurosurg Soc 47 : 332-337, 2010 https://doi.org/10.3340/jkns.2010.47.5.332
  8. Kiemeneij F, Laarman GJ : Transradial artery Palmaz-Schatz coronary stent implantation : results of a single-center feasibility study. Am Heart J 130 : 14-21, 1995 https://doi.org/10.1016/0002-8703(95)90229-5
  9. Kiemeneij F, Laarman GJ, Odekerken D, Slagboom T, van der Wieken R : A randomized comparison of percutaneous transluminal coronary angioplasty by the radial, brachial and femoral approaches : the access study. J Am Coll Cardiol 29 : 1269-1275, 1997 https://doi.org/10.1016/S0735-1097(97)00064-8
  10. Kim JH, Park YS, Chung CG, Park KS, Chung DJ, Kim HJ : Feasibility and utility of transradial cerebral angiography : experience during the learning period. Korean J Radiol 7 : 7-13, 2006 https://doi.org/10.3348/kjr.2006.7.1.7
  11. Laarman G, Muthusamy TS, Swart H, Westendorp I, Kiemeneij F, Slagboom T, et al. : Direct coronary stent implantation : safety, feasibility, and predictors of success of the strategy of direct coronary stent implantation. Catheter Cardiovasc Interv 52 : 443-448, 2001 https://doi.org/10.1002/ccd.1099
  12. Lee DH, Ahn JH, Jeong SS, Eo KS, Park MS : Routine transradial access for conventional cerebral angiography : a single operator's experience of its feasibility and safety. Br J Radiol 77 : 831-838, 2004 https://doi.org/10.1259/bjr/89933527
  13. Levy EI, Boulos AS, Fessler RD, Bendok BR, Ringer AJ, Kim SH, et al. : Transradial cerebral angiography : an alternative route. Neurosurgery 51 : 335-340; discussion 340-342, 2002
  14. Matsumoto Y, Hokama M, Nagashima H, Orz Y, Toriyama T, Hongo K, et al. : Transradial approach for selective cerebral angiography : technical note. Neurol Res 22 : 605-608, 2000 https://doi.org/10.1080/01616412.2000.11740727
  15. Matsumoto Y, Hongo K, Toriyama T, Nagashima H, Kobayashi S : Transradial approach for diagnostic selective cerebral angiography : results of a consecutive series of 166 cases. AJNR Am J Neuroradiol 22 : 704-708, 2001
  16. Moran CJ, Milburn JM, Cross DT 3rd, Derdeyn CP, Dobbie TK, Littenberg B : Randomized controlled trial of sheaths in diagnostic neuroangiography. Radiology 218 : 183-187, 2001 https://doi.org/10.1148/radiology.218.1.r01ja05183
  17. Nohara AM, Kallmes DF : Transradial cerebral angiography : technique and outcomes. AJNR Am J Neuroradiol 24 : 1247-1250, 2003
  18. Park SH, Park JC, Hwang JH, Hwang SK, Hamm IS : Role of three-dimensional computed tomography angiography in the follow-up of patients with aneurysm clips. J Korean Neurosurg Soc 39 : 427-431, 2006
  19. Wu CJ, Hung WC, Chen SM, Yang CH, Chen CJ, Cheng CI, et al. : Feasibility and safety of transradial artery approach for selective cerebral angiography. Catheter Cardiovasc Interv 66 : 21-26, 2005 https://doi.org/10.1002/ccd.20396

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