Year: 2021
Type: conference-abstract
Abstract: Introduction/Purpose In the last 10 years, many practices have transitioned from femoral to a radial-first approach for cerebral angiography. Despite this change in practice, operators continue to use devices, including diagnostic and guide catheters, developed for a femoral approach. To date, only a single radial-specific catheter, the RIST, has come to market. Development of radial-specific devices requires a comprehensive understanding of the geometries, including vessel lengths and angles encountered from a right radial approach. This abstract reports an aortic arch database to assist in radial-specific device development. Materials and Methods Neck CTAs from 100 consecutive patients acquired on a single emergency department 256 slice CT scanner were analyzed retrospectively. Arch characteristics and measurements were obtained from 1 cm MIP reformatted images using McKesson PACs. Data included arch type, angles between the innominate artery and the common carotids, angles at the carotid bifurcations, angles of the vertebral artery origins, and distance from the innominate to the right carotid bifurcation and arch to the left carotid bifurcation and left vertebral origin. Statistical analysis was performed using Excel and R. Results Of the 100 consecutive patients, 1 was excluded due to poor contrast bolus timing. Our database contains 56 female and 43 male patients, average age 63 years old. 45% had type II or III arch configuration, 19% had bovine configuration, and 5% had a left vertebral artery originating directly from the arch. Vessel angles and distances are detailed in table 1. Angles encountered at the arch from the innominate average from 26-54 degrees with a large range, mostly accessible via a reverse curve catheter. Conclusions Trans-radial cerebrovascular angiography presents unique anatomical challenges compared to a traditional trans-femoral approach. For example, the left vertebral artery is often just beyond the reach of a standard Simmons 2 catheter. The geometries and lengths outlined in this abstract will inform bio-inspired design of radial-specific catheters and other devices. Disclosures K. Zerebiec: None. P. Heidari: None. D. Johnson: None. S. Raymond: 1; C; The University of Vermont Health Network Medical Group.
Authors: K Zerebiec, P Heidari, D Johnson, S Raymond
Institution: University of Vermont Medical Center
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W3185506239