Background purpose Clinical outcome in acute ischemic stroke (AIS) patients depends on onset-to-reperfusion time. Therefore, in case of emergency thrombectomy (ET), difficult carotid access leads to worse clinical outcome. Transfemoral approach is common but limited by aortic or peripheral artery conditions and then transbrachial or -radial access is an alternative one. The aim of our study was to investigate the feasibility of transbrachial carotid cannulation (TCC) of a particular long guide-sheath in ET for AIS in the anterior cerebral circulation (ACC).

Methods We included in our retrospective study patients who underwent transbrachial ET as the first line in the ACC with a particular long guide-sheath (MSK-guide 7.5 × 90, 0.088(ID)) from October 2011 to August 2016. We evaluated the patient’s baseline features, sides of occlusion vessels, types of aortic arch (AA), success rate of carotid cannulation and puncture to carotid cannulation time (PTCC_time).

Results Twenty four patients matched our inclusive criteria and were analyzed. Median age was 80.5 years, 16 patients ( 67%) were men, 15 left-sided lesions (63%) were involved. There were 11 patients (46%) with type3 AA, 7 (29%) with type2 AA and 2 with type1 AA. Among them, 4 patients had a bovine arch. Success rate of TCC was 100% and median PTCC_time was 13 min (6 – 18).

Conclusion TCC of a particular long guide-sheath was feasible for ET in the ACC and AA type or peripheral artery conditions didn’t affect procedures.

Disclosures K. Yoshioka: None. T. Mori: None. Y. Tanno: None. N. Nakai: None.