Pigtail catheter exchange technique for the Simmons catheter formation in transradial cerebral angiography

Abstract

Background: The transradial approach (TRA) has become popular for diagnostic cerebral angiography. However, this approach is still used less often because of problematic formation of the Simmons catheter. The purpose of this study was to introduce a pigtail catheter exchange technique for Simmons catheter formation to improve the success rates with a shorter operation time and without increasing complications.

Methods: This retrospective study included consecutive patients eligible for right TRA cerebral angiography at our institution from 2021. To introduce the technique, the cerebral angiogram of formation of the Simmons catheter in the type II aortic arch was constructed. Patient demographic and angiographic data were collected.

Results: In total, 295 cerebral angiographies were evaluated. There were 155 (52.5 %), 83 (28.1 %), 39 (13.2 %), and 18 (6.1 %) patients with types I, II, and III aortic arches and bovine arch, respectively. The total fluoroscopy time, operation time and radiation exposure were 6.3 ± 4.4 min, 17.7 ± 8.3 min and 559.2 ± 197.3 mGy, respectively. The Simmons catheter was successfully formed in 294 of 295 patients, with a success rate of 99.6 %, confirming an effective technique for right TRA cerebral angiography. No severe complications were observed in any patient.

Conclusions: Pigtail catheter exchange may be an effective and safe technique for right TRA cerebral angiography. The findings of this report prompted institutions to apply this technique clinically and can serve as a basis for future trials focused on TRA cerebral angiography.

Keywords: Diagnostic Techniques; Pigtail catheter exchange; Simmons catheter formation.