Direct Percutaneous Infraclavicular Catheterization of the Subclavian Artery

Abstract

S EVERAL procedures have been used to inject opaque material for the purpose of visualizing the vertebrobasilar arterial system. These methods should enable one to visualize the entire course of the vertebral artery from its origin up to and including the basilar artery and its branches. The different techniques may be summarized as follows: 1. Countercurrent injection of opaque material into the common carotid artery. Introduced by Elvidge 5 in 1988. ~. Direct supraclavicular percutaneous puncture of the subclavian artery. This method was introduced by Shimidzu 1~ in 1937, Barbieri and Verdecchia 2 in 1957, and Crawford et al. 4 in 1958. 3. Direct percutaneous infraclavicular puncture of the subclavian artery. This technique was reported by Pouyanne el al. 7 in 1960, and Amplatz and Harner 1 mentioned it in a paper published in 196~. 4. Direct percutaneous infraclavicular cathele,rization of the subclavian artery. This method was introduced by Amplatz and Harner 1 using a needle-catheter combination 6 inches in length. Their preliminary report was published in June 196~. 5. Indirect percutaneous catheterization of the subclavian artery through the brachial artery. This type of retrograde catheterization was reported by Pygott and Hutton s in 1959, Begg 3 in 1960, and Tatelman and Sheehan 12 in 196~. Other techniques have been described in the literature which we considered too complex and too time-consuming for our purpose.