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Carotid-vertebral-brachial angiography with pulmonary hyperpressure

Comments on several technics for the angiographic visualization of the vertebral-basilar system and of the great arteries of the neck are made, as well as some remarks of its difficulties and complications. The percutaneous punction of the brachial arteries associated with pulmonary hyperpressure permitted an easy visualization of the encephalic arterial system from its origin in the aortic arch until the intracranial branches. Pulmonary hyperpressure was obtained maintaining the Takaoka respirator's valve in a position of forced inspiration. Radial pulse is palpated till it is no more felt; 15 to 20 ml of contrast medium are injected after the endotracheal canule is clamped to maintain a constant pulmonary pression. This technic was used in 20 cases without complications; the results were considered from good to excellent in 18 of them. The use of ordinary needles (50X12), small quantities of contrast medium (15 to 20 ml), the simple and common roentgenologic apparatus, the use of only 2-3 X-ray films for a complete examination, as well as the distance of the needle from the neck which permits a free mobilization of the patient's head, the easy demonstration of the great arterial vessels in the neck and of the intracranial vertebral and carotid systems with the punction of only one artery, are the advantages of this method when compared with the others.


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