Our Experience with the Artificial Slow Flow Carotid Angiography

Verbiest and Dokkum (1970) described an unique angiographical technique. Detail of this procedure is as follow; 1) carotid puncture at the level of C-4 or C-5, 2) routine angiography, 3) compression of the ipsilateral common carotid artery at the C-6 level, signs of complete compression are a) disappearance of a pulsein the temporal artery and b) the cessation or reduction of reflux of blood from the angiographic needle, 4) injection of 8 cc of Urographin within about 1.5 sec. 5) first film is exposed when 3 cc were left in the syringe, 6) followed by two exposures with intervals of 1.5 sec. and 7) digital compression is released. We applied this method to two intracranial arterio-venous malformations and two carotid-cavernous fistulas. From this experience we obtained following results; 1) arrest of the contrast medium in the carotid artery, 2) suppression of filling of the anterior and posterior cerebral arteries, 3) this may result in better view of the residual portion of the intracranial vascular pattern, 4) well visualization of arteriovenous malformation and distinguishable a small blood vessels in this lesion, 5) more extensive and heavy staining of the draining veins of a carotid-cavernous fistula.