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• W2105442550 abstract "It is the purpose of this communication to describe an indirect catheterization technic which allows visualization of the entire course of the brachiocephalic vessels in addition to affording excellent demonstration of the intracranial circulation. This method was developed for evaluation of a group of patients with stroke syndrome in the atherosclerotic age group. Since direct needle puncture of diseased arteries is associated with a higher incidence of local complications, an indirect approach was used by catheterization of a single peripheral artery. The right subclavian artery was selected, since it is fairly easily punctured in the older age group, bleeding is successfully controlled, arterial spasm is absent, and good manual control over a very short catheter is possible. By this means the right vertebral artery, the right carotid, the left carotid, and left subclavian arteries can be catheterized under fluoroscopic observation fairly easily, thus allowing demonstration of the extracranial and intracranial circulation. Forty-three patients with stroke syndrome were studied and hemodynamic blood flow measurements were carried out by a radiographic technic (1). Radiographic Anatomy An exact knowledge of the anatomy of the brachiocephalic vessels and their distortion due to atherosclerosis is of practical importance. The bend of the subclavian artery in the region of the scalenus anticus muscle may be markedly accentuated in atherosclerotic patients, making passage of a stiff catheter into the innominate artery extremely difficult. Since the thyrocervical trunk and the vertebral artery arise from the main convexity of this curvature, the catheter tends to enter these vessels spontaneously. Severe atherosclerotic arterial elongation may result in an S-shaped deformity with an additional curvature involving the innominate artery. The left common carotid arises from the aortic arch in close proximity to the origin of the innominate artery (Fig. 1). This close anatomical relationship is fairly constant even in patients with marked atherosclerosis. The distance between the origin of the left carotid artery and left subclavian artery varies considerably, usually being greater in the older age group. On some occasions the left vertebral artery may take its origin from the aortic arch. In these cases its origin lies consistently between the take-off of the left carotid and left subclavian artery, and its selective catheterization usually does not pose technical difficulties (Fig. 2). Technic The right subclavian artery is punctured with an 18-gauge Teflon catheter needle below the clavicle, as previously described (2). The needle is withdrawn and the Teflon catheter is gently advanced until the blood flow stops and a slight thrill is felt within the catheter, usually indicating its correct position in the mouth of the vertebral artery." @default.
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• W2105442550 date "1963-10-01" @default.
• W2105442550 modified "2023-09-26" @default.
• W2105442550 title "A Catheter Approach for Cerebral Angiography" @default.
• W2105442550 cites W1833028058 @default.
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• W2105442550 doi "https://doi.org/10.1148/81.4.576" @default.
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