Percutaneous Brachial Cerebral Angiography

Abstract

C F.R~.Br~L angiography plays an importan t role in the diagnosis of intracranial disease. In some cases, clinical symptoms and physical findings may dictate the need to visualize only a single major artery. However, in many cases visualization of the carotid and vertebral-basilar systems bilaterally may be indicated. This problem has been discussed by Baker ~ and others23 To accomplish this ordinarily requires multiple arterial punctures and injections. This is true particularly if separate injections are required for the visualization of each carotid ar tery and the vertebral-basilar system. Visualization of the entire vascular system from thoracic origin to cranial termination, rather than the cranial circulation alone, also may be important. 8,18 Visualization of the vertebral ar tery sometimes is fraught with considerable difficulty. The development of many approaches and complicated techniques at test to this difficulty. This paper serves to describe a previously unreported, safe technique which has been used fairly extensively at this hospital with excellent results. The technique originally was suggested to one of the authors (E.B.S.) by Dr. E. S. Gurdjian 11 and Dr. Francis Murphey. 16 By means of a single, percutaneous peripheral arterial injection, without catheter or cutdown, serial visualization in two planes of the right internal carotid and vertebral-basilar systems are attained in nearly every case. Because of the ease and safety of this procedure it has replaced direct puncture of the right carotid and vertebral arteries in most patients.