Total Vertebral-Basilar Arteriography via Transbrachial Catheterization1

excerpt There has recently been an increasing awareness of the need for complete angiographic evaluation of all four major arteries supplying the brain in the study of cerebral vascular disease, especially when cerebral vascular insufficiency is suspected. Several recent reports (2, 3, 5, 6, 7, 12, 17, 23, 30) attest to the importance of visualizing all segments of both vertebral arteries as well as both carotid arteries from their origins to their smallest visible intracranial branches. In reviewing a large series of stroke cases in an extension of the work reported by one of us (M. T.) in 1958 (27), we realized that the usual direct percutaneous method of performing vertebral arteriography was inadequate, since many cases with clinical signs of vascular insufficiency showed entirely normal angiographic patterns and in some cases there was even evidence of collateral circulation though no lesion was demonstrated to explain its occurrence (28). It was obvious that a technic was needed that would visualize...