Trans-radial cerebral angiography-safety, efficacy and patient comfort: review of literature

A diagnostic cerebral angiography is a vital tool in the planning and management of various cerebrovascular conditions. Newer angiographic modalities, such as digital subtraction angiography offers dynamic imaging of the cerebral blood flow and is the preferred diagnostic modality of choice when a subsequent intervention is contemplated. Traditionally, the transfemoral route at the groin was used as the site for vascular access. However, landmark randomised controlled trials in the field of interventional cardiology have demonstrated the safety, efficacy and patient comfort attained by employing a trans-radial access for angiography and interventions. This has spawned numerous studies which were directed explicitly towards cerebral angiography and neuro-intervention. We present this review of literature to consolidate the current practices and to encourage the neuro-interventionalists to shift to a radial first approach.

Staged target teaching method of neural interventional therapy for ischemic cerebrovascular disease / 中国脑血管病杂志

Objective To strengthen the training effect of the neuro-interventional surgeons using staged target teaching method. Methods A total of 39 neurosurgeons from all over the country were trained at the Department of Interventional Radiology,Xuanwu Hospital,Capital Medical University from March 2012 to March 2013. In the one-year training period,the training was divided into 4 stages (each stage for 3 months). All the learning contents were phased to focus on teaching and set the target at each stage,which had a clear purpose. Questionnaires were sent to the refresher doctors at 6 months and 12 months after they returned to their original work in order to obtain the conditions about their independent work after training. Results All the 39 neurosurgeons achieved their desired goal from theory to practical operation. They mastered the holistic treatment principles of ischemic cerebrovascular disease and were familiar with and mastered the whole brain DSA and stenting techniques. At the fourth stage,as an operator, everyone had finished at least 5 extracranial artery stentings. The recovered questionnaires after the end of training showed that 95. 8%(23/24)neurosurgeons were able to perform whole brain DSA independently and held≥5 surgeries monthly;87. 5%(21/24)neurosurgeons could complete stenting independently (1 patient/month). Conclusion The staged target teaching method is a practical and effective teaching means for special technical training of neurointervention.