Abstract
OBJECTIVE: To compare the efficacy and safety of cerebral angiography performed using an SM2 catheter combined with a long guidewire exchange technique via transradial approach (TRA) versus the conventional transfemoral approach (TFA). METHODS: Data from 853 patients who underwent diagnostic cerebral angiography between October 2019 and September 2020 were retrospectively reviewed. Patients were divided into a TRA group (n=425) and a TFA group (n=428) according to the vascular access route used. All procedures were performed by experienced neurointerventionalists following a standardized protocol on a uniform imaging system. Primary outcomes were the procedural success rate and the incidence of major complications within 24 hours after the procedure. Secondary outcomes included angiographic completeness, procedure time, fluoroscopy time, radiation dose, and the incidence of all complications during hospitalization. Multivariate logistic regression analysis was performed to adjust for potential confounding factors. RESULTS: The procedural success rate was high in both groups (TRA: 96.71% vs. TFA: 98.83%, P=0.035). Angiographic completeness was significantly higher in the TRA group than in the TFA group (99.27% vs. 87.00%, P < 0.001). Procedure time was shorter in the TRA group (32.4 ± 14.51 min vs. 42.54 ± 22.51 min, P < 0.001). There were no significant differences in fluoroscopy time or radiation dose. The overall complication rate was significantly lower in the TRA group (8.71% vs. 18.46%, P < 0.001), with no pseudoaneurysms observed in the TRA group versus 4.91% in the TFA group. CONCLUSIONS: The SM2 catheter with long guidewire exchange technique via the right radial artery is a safe and effective alternative to the conventional femoral approach for cerebral angiography. It offers shorter procedure times, higher angiographic completeness, and a significantly lower complication profile.