Patient selection, catheters, and contrast agents in intravenous and intra-arterial DSA. Part 2

For reasons discussed in part 1 of this article, some patients are much better candidates for intra-arterial than intravenous digital subtraction angiography. While the intra-arterial methods can be applied to outpatient screening for occlusive vascular disease in the brachicephalic vessels and renal arteries, the specific methodology that provides the best combination of safety and efficacy has not yet been determined. Our rationale, methods and preliminary results of a transbrachial screening procedure using 4F high-flow aortic flush catheters is presented here. Complications and potential risks are discussed. We are currently undertaking a 4F transfemoral study for comparison with the brachial approach.