Abstract
Cerebral angiography is an essential diagnostic procedure in the evaluation of various intracranial vascular diseases. However, catheter cerebral angiographies for neonates and infants are usually neglected because of the technical difficulties and possible occurrence of side effects. In the past two years, selective cerebral angiography via femoral artery catheterization has been performed on 51 cases of neonates and infants with body weight under 10kg in our service. Under general anesthesia, small skin incision was made at the right inguinal region and the right femoral artery was dissected out. Then the catheter was introduced into the exposed femoral artery after systemic heparinization. The dosage of heparin was decided according to the body weight of the patients. Average dosage was approximately 1/mg/kg bodyweight. Polyethylene catheters (Becton Dickinson, Formocath 7620-736) were used, and the tip of the catheter was slightly curved as just like“J”or“S”shape. Under image fluoroscopy, the tip of the catheter was guided through the arch of the aorta and the brachiocephalic artery, then into the right com-mon carotid artery. Three to 5ml of 60 percent Conray was then injected by the auto-injector (Toshiba CIJ-I) with 2-4kg/cm pressure. Successively the top of the catheter was inserted into the left common carotid artery and the left vertebral artery.
After the procedure, Z-suture of the extima at the site of the insertion of the femoral artery was carried out with a nylon yarn (8-0) and thus hemostasis after the withdrawal of the catheter was made. In such a way satisfactory 3 vessel studies were perfomed on 24 cases. Furthermore, we obtained successful results in 43 cases out of 46 cases (93%) when angiography of the vertebral artery was intended. No neurological deficit resulted from the angiographic studies nor were there serious local complications from the femoral artery punctures. In one boy, 11 months old, transitory cardiac arrest for about 1 minute occurred after the left vertebral angiography. This episode was transient and the patient recovered completely. It can be concluded that tansfemoral catheter cerebral angiography is a choice of method in the neonates and infants.
