The safety and feasibility of using a 5-Fr guiding catheter with a 0.035-inch guidewire in place for cerebral angiography

Abstract

Background: This study aimed to evaluate the safety and efficacy of performing diagnostic cerebral angiography using a 5-Fr guiding catheter with a 0.035-inch guidewire in place. Methods: Actual flow rates at different pressures using the 5-Fr guiding catheter with a 0.035-inch guidewire in place were measured in vitro. Integrity of the guidewire surface after high-pressure injection was determined by examination under a light microscope and scanning electron microscope. Injected and unused contrast medium were collected and analyzed using a particle detector. Furthermore, a prospective randomized controlled study was conducted to compare safety and efficacy between the guided (guidewire in place) and conventional methods. Results: The maximum injection pressure at a flow rate of 5 mL/s for the various types of commonly used contrast medium was approximately 350 psi, which is below the pressure limit for cerebral angiography. The guidewire surface remained relatively intact after multiple high-pressure injections. Procedure success and primary success rates did not significantly differ between the guided and conventional methods. However, procedure time (25.93 ± 4.07 vs 31.55 ± 5.49 minutes) and radiation exposure time (12.16 ± 3.82 vs 17.27 ± 6.12 minutes) were significantly shorter in the guided method group. Conclusion: The guided catheterization method is safe and feasible for cerebral angiography and has several advantages over the conventional method.