E-038 Transradial neuro-angiography by re-wiring of arterial line

R Dossani, M Waqas, M Tso, G Rajah, H Rai, A Levy, A Siddiqui, J Davies
2020 Electronic Poster Abstracts   unpublished
between the two modalities. Safety was assessed through quantifying the number of complications with central venous lines (CVL) or external ventricular drains (EVD) attributable to the LUCID device. Results Nine patients (average age = 66 yrs) with subarachnoid hemorrhages or aneurysms underwent a total of 21 LUCID TCDs to assess the MCAs for vasospasm. The autonomous motion of the LUCID TCD ultrasound transducers did not displace or impinge on CVLs/EVDs. Moreover, LUCID acquired maximum MCA
more » ... ocities and angiography moderately agree with a Cohen's Kappa value of 0.61 (p=0.005). Conclusions This investigation demonstrates that LUCID TCD as a modality to probe for MCA vasospasm is a viable option as LUCID maximum MCA velocities and angiography are moderately congruent. Additionally, LUCID TCD is safe to use clinically as it poses minimal risk to a patient's CVL or EVD. Background The advantages of transradial neuroangiography over a transfemoral access with respect to fewer access site complications, shorter procedure duration and better patient comfort are well described. Radial arterial lines are routinely placed in the ICU in critically ill neurosurgical patients and in the OR on patients undergoing complex neurovascular procedures. We describe the utility of rewiring a radial arterial line in exchange for an arterial sheath for the purpose of diagnostic cerebral arteriography or neurointervention. Rewiring a radial arterial line has the practical benefit of avoiding repeat needle puncture in the setting of an existing catheter that can be ready exchanged for an arterial sheath using a wire exchange technique. Methods Consecutive patients who had transradial neuroangiography through arterial line access over the 12 months were included in the study. The technique for transradial access was modified in the presence of arterial line. The Arterial line catheter was re-wired and exchanged with 5Fr or 6 Fr sheath as necessary. Data on demographics, indication, devices, and complications was recorded and analyzed. Results Twelve procedures were performed on 11 patients. Mean age was 58.6 +12.9 years; 7 were female. Seven procedures were performed using left-sided arterial line access while 5 procedures were performed using the right side. The most common indication was post-operative angiogram after clipping of aneurysms (n=8), coiling of anterior communicating artery aneurysm (n=1), arteriovenous fistula surgery (n=1). Two cases were performed to evaluate intraventricular hemorrhage (n=1), and arteriovenous malformation resection (n=1). No access site complication was observed. The radial artery sheath was either removed or sutured in place to be used as an arterial line if the patient needed to return to the operating room or the ICU.
doi:10.1136/neurintsurg-2020-snis.74 fatcat:epedxg55ineqbcrkv45c7cwsle