Abstract
A new method for a selective or superselective angiography devised by us was attempted to the clinical evaluation. The catheterization was performed through the brachial artery instead of the femoral route using a long, soft and slender catheter led to the target artery with a guidewire. DSA-apparatus was applied in order to obtain the high resolution images by the injection of a small quantity of contrast media with resulting little adverse reactions. This procedure was named TB-SDSA (Trans Brachial Selective Digital Subtraction Angiography.)
The insertion of a catheter into the target artery was technically achieved in 97.5% of 80 examinations in 29 patients with hepatoma by this procedure and in failed two by transfemoral, In this series hepatoma recognized as definite darker stains was found in 27 patients. In eleven out of the 27, small solitary or multiple tumors with diameter less than 1 cm were confirmed and all of these were undetected by a routine CT and US. It was considered to be metastatic focuses in the nine patients and primary in the two of the 11 patients.
Serious complications such as bleeding from the catheter punctured arteries, hypotension, discomforts or the others were not experienced in outpatients as well as in inpatients. No patients refused the re-examination even at short intervals because of minimal side effects, restoration of full activities after the operation and lack of the mental repugnance against the trans-femoral catheterization.
These advantages enabled us to repeat the examination, TAB-treatment and infusion of drugs into the target artery.
The TB-SDSA is believed to be very useful in the examinations, especially the early detection and treatment of hepatoma.
