Cerebral microembolism during coronary angiography: a randomized comparison between femoral and radial arterial access.

Abstract

Microemboli observed during coronary angiography can cause silent ischemic cerebral lesions. The aim of this study was to investigate if the number of particulate cerebral microemboli during coronary angiography is influenced by access site used. Fifty-one patients with stable angina pectoris referred for coronary angiography were randomized to right radial or right femoral arterial access. The number of particulate microemboli passing the middle cerebral arteries was continuously registered with transcranial Doppler. The median (minimum-maximum range) numbers of particulate emboli were significantly higher with radial 10 (1-120) than with femoral 6 (1-19) access. More particulate microemboli passed the right middle cerebral artery with the radial access. This study indicates that the radial access used for coronary angiography generates more particulate cerebral microemboli than the femoral access and thus may influence the occurrence of silent cerebral injuries.