Belatedly, I read the above-mentioned article written by Cloft et al (1) and published in the March 2000 issue of AJNR. It seems that our younger colleagues do not pay enough attention to the older medical literature: in 1975, an article (2) dealing with exactly the same topic was published. It enumerated exactly the same causes of damage in the brachiocephalic arteries due to the catheter angiography and had exactly the same conclusions. At that time, we redesigned the multipurpose catheter that we used for brachiocephalic angiography in such a way that the tip of the catheter did not direct the injected contrast against the vessel wall but into the bloodstream and that it was difficult to wedge into the vessel wall. Other work (3, 4) also deserves to be mentioned. The value of Dr Cloft’s article is that he reminded younger neuroradiologists of the possibility that iatrogenic damage to the brachiocephalic arteries during diagnostic or interventional procedures may occur and discussed how to avoid them.
Reply:
I apologize to Dr Vitek for overlooking his earlier work. I appreciate his pointing this out to the neuroradiology community so that we can all learn from his work and the work of others.
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