RT Journal Article SR Electronic T1 Predicting the degree of difficulty of the trans-radial approach in cerebral angiography JF Journal of NeuroInterventional Surgery JO J NeuroIntervent Surg FD BMJ Publishing Group Ltd. SP 552 OP 558 DO 10.1136/neurintsurg-2020-016448 VO 13 IS 6 A1 Nickalus R Khan A1 Jeremy Peterson A1 David Dornbos III A1 Vincent Nguyen A1 Nitin Goyal A1 Radmehr Torabi A1 Daniel Hoit A1 Lucas Elijovich A1 Violiza Inoa-Acosta A1 David Morris A1 Christopher Nickele A1 Pascal Jabbour A1 Eric C Peterson A1 Adam S Arthur YR 2021 UL http://jnis.bmj.com/content/13/6/552.abstract AB Background To evaluate anatomical and clinical factors that make trans-radial cerebral angiography more difficult.Methods A total of 52 trans-radial diagnostic angiograms were evaluated in a tertiary care stroke center from December 2019 until March 2020. We analyzed a number of anatomical variables to evaluate for correlation to outcome measures of angiography difficulty.Results The presence of a proximal radial loop had a higher conversion to femoral access (p<0.03). The presence of a large diameter aortic arch (p<0.01), double subclavian innominate curve (p<0.01), left proximal common carotid artery (CCA) loop (p<0.001), acute subclavian vertebral angle (p<0.01), and absence of bovine aortic arch anatomy (p=0.03) were associated with more difficult trans-radial cerebral angiography and increased fluoroscopy time-per-vessel.Conclusion The presence of a proximal radial loop, large diameter aortic arch, double subclavian innominate curve, proximal left CCA loop, acute subclavian vertebral angle, and absence of bovine aortic arch anatomy were associated with more difficult trans-radial cerebral angiography. We also introduce a novel grading scale for diagnostic trans-radial angiography.All data relevant to the study are included in the article or uploaded as supplementary information.