Technical Feasibility and Safety of Transaxillary Artery Approach for Cerebral Angiography—a Case Report and Review of Literature

Abstract

Introduction
Transfemoral approach has been the most used approach
for cerebral angiography for decades until recent intro‐
duction of the transradial approach. Despite the techni‐

cal feasibility and ease of catheterization of the supra-
aortic vessels, accessing this route can be difficult in

patients with aortoiliac and iliofemoral disease. The
transradial approach is a safer alternative for cerebral
angiography and has shown to have a better safety pro‐
file [1,2]. However, this approach is not feasible in
patients with radial artery occlusion associated with pre‐
vious catheterization or thromboangiitis obliterans.
Transaxillary was first described in 1963 [3,4], but its
use has slowly declined over the years due to potential
complications, including limb ischemia and nerve injury,
when access was carried out without any visualization of
the arterial lumen. We describe ultrasound-guided trans‐
axillary access as an alternative and safe approach to
cerebral angiography in patients with comorbidities lim‐
iting the transfemoral or transradial approach.