Feasibility and Safety of a Computer-Controlled Device for Transradial Cerebral Angiography: A Prospective Pilot Study.

OBJECTIVE

This study aimed to evaluate the feasibility and safety of a computer-controlled local anesthetic delivery device during transradial cerebral angiography and to descriptively assess procedural pain and hemodynamic changes in an initial series of patients.

METHODS

In this prospective pilot study, 10 consecutive adult patients undergoing elective diagnostic cerebral angiography via the radial artery received local anesthesia with a computer-controlled injection device using 1 mL of 3% mepivacaine delivered through a 33-G needle. The primary outcome of this study was feasibility, defined as successful delivery of local anesthesia and completion of transradial access without device-related complications or the need to convert to manual injection. Secondary outcomes included pain intensity assessed using a 0-100-mm visual analogue scale (VAS) at predefined procedural steps, hemodynamic changes before and after sheath insertion, and access-site adverse events such as vasospasm or bleeding. Blood pressure was compared between baseline (immediately before local anesthesia) and after sheath insertion.

RESULTS

All 10 procedures were successfully completed using the computer-controlled device without device malfunction, conversion to manual injection, or access failure. The first puncture attempt was successful in all patients. The median VAS score following local anesthesia was 18 [13-22] mm, following arterial puncture was 3 [2-4.75] mm, and following sheath insertion was 7.5 [3-10] mm. There was no significant difference in median systolic blood pressure before local anesthesia and after sheath insertion (160.7 ± 30.6 vs. 160.1 ± 27.6 mmHg; p = 0.84), and diastolic blood pressure also did not change significantly (80.5 ± 6.2 vs. 77.5 ± 10.0 mmHg; p = 0.16). No clinically evident radial artery spasm or hemorrhagic access-site complications occurred.

CONCLUSION

In this pilot study, computer-controlled local anesthesia during transradial cerebral angiography was feasible and appeared safe in a small cohort of patients. Pain-related findings should be interpreted as descriptive and hypothesis-generating, and further controlled studies are required to evaluate efficacy.