The Influence of Flush Methods on Transfemoral Catheter Cerebral Angiography: Continuous Flush versus Intermittent Flush

Abstract

Purpose: To evaluate the influence of different flush methods on transfemoral cerebral angiography (TFCA). Materials and Methods: This single-blind randomized controlled trial included 50 patients who had undergone TFCA. Balanced block randomization was used to allocate participants into intermittent-flush (n = 25) and continuous-flush (n = 25) groups. Differences in procedure duration, amounts of contrast medium and heparinized saline used, heparin dose, blood loss, fluoroscopy time, radiation dose; and occurrence of new embolic signal (NES) on diffusion-weighted imaging (DWI) were compared between the two groups. Results: The procedure duration was shorter in the continuous-flush group (mean 26.5 min +/- 3.7) than in the intermittent-flush group (mean 29.6 min +/- 2.8) (P = .004). Amounts of injected contrast medium (mean 20.2 mL +/- 4.4 vs 57.1 mL +/- 9.0), wasted heparinized saline (mean 19.8 mL +/- 9.6 vs 92.3 mL +/- 16.7), and aspirated blood (mean 4.7 mL +/- 1.3 vs 13.2 mL +/- 2.9) were lower in the continuous-flush group than in the intermittent-flush group (P < .001). The amount of injected (or infused) heparinized saline, heparin dose, fluoroscopy time, radiation dose, and occurrence of NES on DWI did not differ between the groups (P > .05). Conclusions: The use of continuous flushing during TFCA reduced the procedure time, amount of contrast medium needed, amount of wasted heparinized saline, and blood loss, but no difference in the occurrence of NES on DWI was noted between the groups.