Article

Percutaneous Retrograde Carotid Arteriography: A New Technic

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Abstract

ROENTGENOGRAPHIC demonstration of arteries in the neck, the chest, and the upper extremities is possible with a new technic (Fig. 1) that is safe, simple, and is easily performed.

Initially we employed retrograde injections of the carotid arteries to visualize the origin of the carotid artery. We discovered that injection of the right carotid artery permitted visualization of the innominate, subclavian, vertebral, and brachial arteries, while injection of the left carotid artery permitted visualization not only of the carotid take-off, but also of the descending aorta and, occasionally, the left subclavian artery. The courses of these vessels could be conveniently studied.

Retrograde injections were used in a series of 16 patients as an aid in diagnosing atherosclerotic lesions. No unfavorable side-effects were produced.

Technic

Endotracheal anesthesia was used in 14 patients, and local anesthesia with 1 per cent procaine hydrochloride, was used in 2 patients.

In the anesthetized patient, a No. 18 gauge needle is inserted percutaneously in the common carotid artery. Any technic for carotid artery puncture may be used for retrograde studies, but the needle should be inserted into the carotid artery pointing downward (Fig. 2).

The patient’s chin should be slightly rotated to the side opposite injection, to give the operator accessibility to the distal common carotid artery for compression. Manual compression is applied to the artery above the needle puncture. Obstructing the cephalad flow permits more contrast medium to be sent toward the origin of the carotid artery.

For injections of the right carotid artery, a . . .


 

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