Trans-radial spinal angiography: A single-center experience

Abstract

Introduction Spinal angiography (SpAn) is the gold standard for diagnosis of spinal dural fistulas and arteriovenous malformations. A complete spinal angiogram necessitates the interrogation of the segmental arteries arising from the aorta at every level as well, the internal iliac; and median sacral arteries at the caudal end; and the cervical vasculature at the cranial end. SpAn has traditionally been performed with transfemoral arterial access and could be challenging. Of late, transradial arterial access has emerged as a popular alternative for endovascular surgical Neuroradiology (ESN) procedures including SpAn. However, there is paucity of the literature regarding transradial access for spinal angiography. Methods After IRB approval, records and imaging were reviewed in a series of patients who underwent SpAn at our institution. Results A total of nine spinal angiograms were performed via transradial access in a consecutive series of eight patients between July 2019 and December 2020 at our institution. Eight of these were diagnostic SpAn's, and one patient underwent SpAn with transradial approach for the treatment of a type I spinal dural arteriovenous fistula. No complications occurred during or subsequent to the procedures. Conclusion SpAn can be successfully and safely accomplished via transradial access. This approach appears to provide a stable method for interventions, as well.

A Case of Craniocervical Junction Arteriovenous Fistulas with a Brainstem Mass Lesion on Imaging: Case Report and Literature Review

“…Additionally, CTA does not have a high detection rate for arteriovenous fistulas (AVFs). The diagnosis of AVF is not complicated, and DSA is the gold standard for diagnosis [20]. Studies have also performed adjunctive diagnosis using indocyanine green [21][22][23] or performing MRI [24], but for most clinical centers, DSA is the most reliable and convenient diagnostic modality.…”