2 research outputs found
Complications of lower-extremity outpatient arteriography via low brachial artery
We retrospectively evaluated low brachial artery puncture for
arteriography and its complications as an alternative approach route for
bilateral lower extremity run-off. Using the Seldinger technique and
catheterization with a sheathless 4-F multiple side-hole pigtail
catheter, we performed 2250 low brachial artery punctures in
outpatients. The right brachial artery (RBA) was successfully punctured
in 2039 patients; the left brachial artery (LBA) in 200. The
transfemoral approach was used in 11 patients when catheterizing either
of brachial arteries failed. Ten major or moderate complications (2
pseudoaneurysms, 2 thrombosis, 1 dissection and 5 hematomas) were
encountered. Surgical intervention was necessary in three cases. There
were no transient ischemic attacks. Twenty-one patients suffered
temporary loss of radial pulse which returned spontaneously in less than
1 hour. One patient demonstrated prolonged loss of pulse which required
heparin. Low brachial artery puncture and catheterization at the
antecubital fossa is a very safe and cost-effective alternative to the
femoral artery approach for lower extremity intra-arterial arteriography
in the hands of experienced operators. The success rate in catheterizing
one of the brachial arteries was 99.52% with a low significant
complications rate of 0.44%. The transbrachial approach should be used
as a standard method for lower extremity IA-DSA in an outpatient
setting