J Korean Neurosurg Soc.  2018 Jan;61(1):51-59. 10.3340/jkns.2017.0209.

Complications Following Transradial Cerebral Angiography : An Ultrasound Follow-Up Study

• Yoon W
• Kwon WK
• Choudhri O
• Ahn J
• Huh H
• Ji C
• Do HM
• Mantha A
• Jeun SS

• KMID: 2403523
• DOI: http://doi.org/10.3340/jkns.2017.0209

Abstract

OBJECTIVE
The feasibility and usefulness of transradial catheterization for coronary and neuro-intervention are well known. However, the anatomical change in the catheterized radial artery (RA) is not well understood. Herein, we present the results of ultrasonographic observation of the RA after routine transradial cerebral angiography (TRCA).
METHODS
Patients who underwent routine TRCA with pre- and post-procedure Doppler ultrasonography (DUS) of the catheterized RA were enrolled. We then recorded and retrospectively reviewed the diameter and any complicated features of the RA observed on DUS, and the factors associated with the diameter and complications were analyzed.
RESULTS
A total of 223 TRCAs across 181 patients were enrolled in the current study. The mean RA diameter was 2.48 mm and was positively correlated with male gender (p < 0.001) and hypertension (p < 0.002). The median change in diameter after TRCA was less than 0.1 mm (range, -1.3 to 1.2 mm) and 90% of changes were between -0.8 and +0.7 mm. Across 228 procedures, there were 12 cases (5.3%) of intimal hyperplasia and 22 cases (9.6%) of asymptomatic local vascular complications found on DUS. Patients with abnormal findings on the first procedure had a smaller pre-procedural RA diameter than that of patients without findings (2.26 vs. 2.53 mm, p=0.0028). There was no significant difference in the incidence of abnormal findings for the first versus subsequent procedures (p=0.68).
CONCLUSION
DUS identified the pre- and post-procedural diameter and local complications of RA. Routine TRCA seems to be acceptable with regard to identifying local complications and changes in RA diameter.

Keyword

Cerebral Angiography; Radial Artery; Ultrasonography

MeSH Terms

Catheterization
Catheters
Cerebral Angiography*
Follow-Up Studies*
Humans
Hyperplasia
Hypertension
Incidence
Male
Radial Artery
Retrospective Studies
Ultrasonography*
Ultrasonography, Doppler

Figure

• 

  Fig. 1. A case of radial artery occlusion. A : This shows a pre-procedural normal radial artery with an intact lumen and vessel wall. B : This is the normal Doppler wave-form of the ulnar artery at the post-procedure follow-up. C : In contrast to (A) and (B), there is vague echogenicity in the lumen, which is assumed to indicate thrombus formation. D : The Doppler shows an obstructive wave pattern.

• 

  Fig. 2. Doppler ultrasonographic findings of various complications. A and B : A dissection of a radial artery in cross-sectional and longitudinal view. Note the double lumen sign. In the Doppler image that is not shown in this figure, the false lumen did not have any blood flow signal. C : An aneurysmal change in the radial artery around the puncture site (asterisk). D and E : A pseudoaneurysm case in Doppler and gray scale images. The pseudoaneurysm sac does not appear to have a proper wall and shows mixed Doppler signals due to the turbulent blood flow. F : A case of arteriovenous fistula.

Reference

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