EVALUATING THE EFFICACY AND SAFETY OF THE TRANS-RADIAL ARTERY APPROACH FOR CEREBRAL ANGIOGRAPHY

Abstract

Cerebral angiography is an essential diagnostic tool for evaluating neurovascular conditions. Traditionally performed via the transfemoral approach, this technique carries notable risks such as bleeding, hematoma, and prolonged recovery.

Objective: To assess the effects and safety of the trans-radial artery approach for performing diagnostic cerebral angiography.

Methods: This prospective observational study was conducted at Services Hospital Lahore  from November 2024 to April 2025. A total of 355 patients who were referred for diagnostic cerebral angiography and deemed suitable for trans-radial access were enrolled. Written informed consent was obtained from all participants. Data were collected using a structured proforma. All procedures were performed in a dedicated neuro-angiography suite by experienced interventional radiologists trained in TRA. Under sterile conditions and local anesthesia, radial artery cannulation was performed using a micro-puncture technique.

Results: Technical success was achieved in 337 out of 355 patients (94.9%). The most common indications were suspected aneurysm (38.0%) and ischemic stroke workup (29.6%). Minor complications occurred in 6.8% of cases, primarily radial artery spasms and small hematomas; no major complications were observed. The mean fluoroscopy time was 12.4 ± 4.6 minutes, and the average contrast usage was 83.1 ± 15.8 mL. Over 91% of patients were ambulatory within two hours post-procedure, and 85.9% reported minimal discomfort.

Conclusion: It is concluded that the trans-radial artery approach is a safe and effective alternative to the femoral route for cerebral angiography. TRA demonstrated high procedural success with a low complication rate and excellent patient tolerance, supporting its broader adoption in neuro-interventional practice.