Procedure Dynamics in Transfemoral vs Transradial Cerebral Angiography: A Retrospective Study.

Abstract

BACKGROUND Cerebral angiography, although invasive, remains the most accurate diagnostic tool for neurovascular diseases. While transfemoral cerebral angiography (TFCA) is the conventional approach, transradial cerebral angiography (TRCA) has gained interest due to potential benefits, such as reduced hematoma risk and shorter recovery times. However, procedure times and influencing factors remain debated. This retrospective study from a single center aimed to compare procedure time in 100 patients undergoing conventional TFCA and 93 undergoing TRCA. MATERIAL AND METHODS This single-center retrospective study included 193 patients who underwent 4-vessel cerebral angiography from January to December 2023. TFCA and TRCA were performed by experienced neurosurgeons. TRCA involved radial artery access with collateral circulation assessment (modified Allen's and Barbeau's tests), and TFCA used femoral artery access with standard techniques. Clinical data, including puncture times and radiation exposure, were collected. Logistic regression identified factors influencing prolonged procedure times (>20 minutes). RESULTS Procedure times for TFCA and TRCA were similar (median: 20.00 minutes vs 24.50 minutes, p=0.139), though TRCA showed longer puncture times (median: 10.00 vs 10.00 minutes, p=0.001). Radiation exposure was comparable (421.00 milliGray (mGy) vs 418.50 mGy, p=0.530). Hypertension (OR: 2.255, p=0.011) and aortic arch tortuosity (OR: 3.881, p=0.002) significantly influenced prolonged procedures. CONCLUSIONS TRCA offers a safe and effective alternative to TFCA for diagnostic cerebral angiography, with comparable procedure times and radiation exposure. While patient-specific factors, such as hypertension and aortic arch tortuosity, influence procedure duration, TRCA provides benefits in patient comfort and recovery. These findings support the broader use of TRCA in diagnostic settings.