Keywords:
Catheter arteriography, Vascular, Neuroradiology brain, Interventional vascular, Fluoroscopy, Ultrasound, Arterial access, Stents, Embolisation, Embolism / Thrombosis, Aneurysms, Arteriovenous malformations
Authors:
I. RODRIGUEZ CAAMAÑO, R. Barranco Pons, O. Chirife, S. Aixut Lorenzo, L. Aja Rodríguez, M. A. De Miquel; Barcelona/ES
DOI:
10.26044/ecr2019/C-1328
Methods and materials
- All patients had a previous positive Barbeau test
- We used ultrasound guidance with Hockey stick transducer
- A 2mm minimum arterial diameter was required
Fig. 5: Ultrasound view of the radial artery and minimum diameter required.
Materials:
The sheath and catheter combinations that were used :
-7F sheath and Cello 6F
Mechanical trombectomy using balloon occlusion aspiration.
-6F Sheath with ACE68
Mechanical thrombectomy using distal aspiration.
-Cook 6F shuttle with a 6F intermediate catheter
Mechanical thrombectomy using distal aspiration and in Flow diverter stent placement in anterior circulation aneurysms.
-6F sheath with Simmons 2 guiding catheter
Aneurysm treatment with balloon assisted coiling
Technique:
1.
The arm to be accessed is placed next to the patient with the forearm and the hand in a slight supine position.
Fig. 1: Ultrasound guidance
2.
Under ultrasound guidance,
the area is anesthetized locally with 2% mepivacaine and the artery punctured with a 21G needle using the Seldinger technique.
Fig. 2: Radial artery puncture after local anesthesia
3.
After radial artery catheterization,
we introduce a 4-6F/cm introducer.
Fig. 3: Sheath placement after radial artery catheterization using Seldinger technique
4 .
A cocktail infusion of 2.5 mg verapamil and 2000UI heparine mixed with blood is infused in order to prevent thrombosis and vasospasm.
Fig. 4: Injection of cocktail to prevent vasospasm and radial artery occlusion