Aims and objectives
There is extensive experience in the use of transfemoral access (TFA) in interventional neuroradiology,
being the most frequent vascular access used for catheterization of supra-aortic trunks and intracranial vessels.
Transradial access (TRA ),
is used systematically in cardiology procedures were randomized studies support its safetyand low rate of local complications in the puncture site,
as well of reduction of the of hospital stay with greater tolerability for the patients.
For these reasons TRA is progressively being adopted in neuroradiology ,
either to perform diagnostic angiographies...
Methods and materials
All patients had a previous positive Barbeau test
We used ultrasound guidance with Hockey stick transducer
A 2mm minimum arterial diameter was required
Materials:
The sheath and catheter combinations that were used :
-7F sheath and Cello 6F
Mechanical trombectomy using balloon occlusion aspiration.
-6F Sheath with ACE68
Mechanical thrombectomy using distal aspiration.
-Cook 6F shuttle with a 6F intermediate catheter
Mechanical thrombectomy using distal aspiration and in Flow diverter stent placement in anterior circulation aneurysms.
-6F sheath with Simmons 2 guiding catheter
Aneurysmtreatment with...
Results
Table 1
We performed a total of 35 neurointerventional procedures(table 1) in 18 female and 13 men with ages ranging from 42 to 89 y.o (mean 64 y.o)
Right radial vascular access was used in all of them and in 2 cases both radial arteries
Procedures include 12 strokes using mechanical thrombectomy,
16 aneurysm embolization and other procedures such as AVMs,
carotid-cavernous fistulas and carotid stenosis.
No vascular access-related complications occurred in any case.
Only in 1 case,
we couldn't perform mechanical thrombectomy after the...
Conclusion
Feasible (requires learning curve)
No major bleeding,
therefore,
less morbidity
Early discharge
Cost-effective
Preferred by patients
Diagnostic and therapeutic procedures
A new and useful tool for the neuro interventionists
References
Snelling BM,
South S,
Shah SS,
Marlow MM,
Cohen MG,
Peterson EC.
Transradial access: lessons learned from cardiology 2017;
Snelling BM,
Sur S,
Shah SS,
Khandelwal P,
Caplan J,
Haniff R,
et al.
Transradial cerebral angiography : techniques and outcomes.
2018;(January 2016)
Haussen DC,
Nogueira RG,
Desousa KG,
Pafford RN,
Janjua N,
Ramdas KN,
et al.
Transradial access in acute ischemic stroke intervention.
2015
Sur S,
Snelling B,
Khandelwal P,
Caplan JM.
Transradial approach for mechanical thrombectomy in anterior circulation large-vessel occlusion