Feasibility and Safety of a Computer-Controlled Device for Transradial Cerebral Angiography: A Prospective Pilot Study

Shun Tanaka; Koji Hirata; Koichi Uramaru; Hideaki Matsumura; Takeshi Yoshimoto; Hisayuki Hosoo; Yoshiro Ito; Mikito Hayakawa; Aiki Marushima; Hiroshi Yamagami; Yuji Matsumaru

doi:10.5797/jnet.oa.2026-0040

Feasibility and Safety of a Computer-Controlled Device for Transradial Cerebral Angiography: A Prospective Pilot Study

J Neuroendovasc Ther. 2026;20(1):2026-0040. doi: 10.5797/jnet.oa.2026-0040. Epub 2026 May 27.

Authors

Shun Tanaka^{1

2}, Koji Hirata¹, Koichi Uramaru¹, Hideaki Matsumura¹, Takeshi Yoshimoto¹, Hisayuki Hosoo^{1

3}, Yoshiro Ito^{1

4}, Mikito Hayakawa^{1

5}, Aiki Marushima^{1

4}, Hiroshi Yamagami^{1

3}, Yuji Matsumaru^{1

4}

Affiliations

¹ Department of Stroke and Cerebrovascular Diseases, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan.
² Doctoral Program in Medical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan.
³ Division of Stroke Prevention and Treatment, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
⁴ Department of Neurosurgery, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
⁵ Department of Neurology, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.

Abstract

Objective: This study aimed to evaluate the feasibility and safety of a computer-controlled local anesthetic delivery device during transradial cerebral angiography and to descriptively assess procedural pain and hemodynamic changes in an initial series of patients.

Methods: In this prospective pilot study, 10 consecutive adult patients undergoing elective diagnostic cerebral angiography via the radial artery received local anesthesia with a computer-controlled injection device using 1 mL of 3% mepivacaine delivered through a 33-G needle. The primary outcome of this study was feasibility, defined as successful delivery of local anesthesia and completion of transradial access without device-related complications or the need to convert to manual injection. Secondary outcomes included pain intensity assessed using a 0-100-mm visual analogue scale (VAS) at predefined procedural steps, hemodynamic changes before and after sheath insertion, and access-site adverse events such as vasospasm or bleeding. Blood pressure was compared between baseline (immediately before local anesthesia) and after sheath insertion.

Results: All 10 procedures were successfully completed using the computer-controlled device without device malfunction, conversion to manual injection, or access failure. The first puncture attempt was successful in all patients. The median VAS score following local anesthesia was 18 [13-22] mm, following arterial puncture was 3 [2-4.75] mm, and following sheath insertion was 7.5 [3-10] mm. There was no significant difference in median systolic blood pressure before local anesthesia and after sheath insertion (160.7 ± 30.6 vs. 160.1 ± 27.6 mmHg; p = 0.84), and diastolic blood pressure also did not change significantly (80.5 ± 6.2 vs. 77.5 ± 10.0 mmHg; p = 0.16). No clinically evident radial artery spasm or hemorrhagic access-site complications occurred.

Conclusion: In this pilot study, computer-controlled local anesthesia during transradial cerebral angiography was feasible and appeared safe in a small cohort of patients. Pain-related findings should be interpreted as descriptive and hypothesis-generating, and further controlled studies are required to evaluate efficacy.

Keywords: cerebral angiography; computer-controlled local anesthesia; pain management; radial artery; transradial approach.