The authors report their experience with intraarterial digital subtraction angiography (DSA) performed on outpatients via brachial artery catheterization. A total of 120 outpatients were studied for cerebral and lower limbs vascular diseases. Transbrachial catheterization was performed with 5F or, preferably, with 4F angiographic catheters. Success rate was high and the transbrachial approach was always easy. In the course of cerebral examination (18/120 cases) the catheter was always easily positioned in the ascending thoracic aorta, through right transbrachial approach. In the course of abdominal aorta and lower extremities examination (102/120 cases), the ideal catheter positioning--in the descending aorta--was performed in 95/102 cases, by left transbrachial approach, while in 7/102 patients the catheter was placed in the ascending aorta. The complication rate was low: 7/120 ecchymosis, 4/120 small hematomas spontaneously resorbed, and 2/120 transient spasms of brachial artery. The authors suggest trasbrachial intraarterial DSA as an alternative to intravenous DSA in outpatients.
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J Clin Med
December 2024
Department of Neurosurgery, Myodani Hospital, Kobe 655-0852 Hyogo, Japan.
Carotid artery stenting (CAS) has traditionally been performed using the transfemoral approach (TFA). Recently, the transradial approach (TRA) has gained attention for its lower invasiveness and reduced complication risk. This study compares outcomes between two access strategy timeframes, TFA-first and TRA-first, to evaluate how this shift influences outcomes in a real-world setting.
View Article and Find Full Text PDFCarotid artery stenting (CAS) has been established as an effective surgical treatment for internal carotid artery stenosis and/or common carotid artery stenosis (ICAS/CCAS). Typically, CAS is performed via a transfemoral, transbrachial, or transradial approach. However, direct puncture CAS (DP-CAS) is preferred in cases where conventional access routes are challenging, such as in the presence of cervical vascular tortuosity or thoracic aortic aneurysm.
View Article and Find Full Text PDFCureus
September 2024
5th Surgical Department, Hippokrateio General Hospital, Aristotle University of Thessaloniki, Thessaloniki, GRC.
Background Endovascular aneurysm repair (EVAR) has evolved into treatment of choice for infrarenal abdominal aortic aneurysms (AAA). Type II endoleaks, although frequently benign, can lead to sac enlargement and rupture. Management of these endoleaks by endovascular means can be quite challenging and may require complex techniques and assistance of interventional radiologists, not always available in all vascular units.
View Article and Find Full Text PDFVascular
August 2024
Division of Vascular and Interventional Radiology, Joint Department of Medical Imaging, Toronto, ON, Canada.
J Neuroendovasc Ther
June 2024
Department of Neurosurgery, Gifu Prefectural Medical Center, Gifu, Gifu, Japan.
Objective: In cases of severe atherosclerosis or tortuous arteries, inserting the guiding sheath into the target vessel is challenging. Here, we present the turn-over technique for inserting and stabilizing the guiding sheath without straightening it during carotid artery stenting (CAS).
Case Presentation: Two patients with severe left internal carotid artery stenosis underwent CAS via the trans-brachial approach.
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