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New Devices and Techniques
Original research
Fast-track incorporation of the transradial approach in endovascular neurointervention
  1. Eyad Almallouhi1,
  2. Jonathan Leary2,
  3. Jeffrey Wessell3,
  4. Sami Al kasab3,
  5. Suhas Pai3,
  6. Mithun G Sattur3,
  7. Jonathan R Lena3,
  8. Alejandro M Spiotta3
  1. 1 Department of Neurology, Medical University of South Carolina, Charleston, South Carolina, USA
  2. 2 College of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
  3. 3 Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA
  1. Correspondence to Dr. Alejandro M Spiotta, Neurosurgery, Medical University of South Carolina, Charleston, SC 29425, USA; spiotta{at}musc.edu

Abstract

Background The transradial approach as a frontline approach is a novel technique in neuroendovascular procedures. In this study we aim to present our early experience with full transition to transradial access as the first-line approach for neuroendovascular procedures.

Methods We prospectively collected data on the first 100 consecutive patients who underwent a diagnostic or interventional neuroendovascular procedure using the transradial approach at our institution between March 22 and April 30, 2019. Baseline characteristics were collected in addition to the type of procedure, access site, catheters and wires used, complications, and whether there was crossover to transfemoral access.

Results Transradial access was attempted in 121 cases and 91 cases were completed successfully (72 diagnostic procedures and 19 interventional procedures). Mean (SD) age was 56.8 (14.7) years, 54.9% (50/91) underwent the procedure in the outpatient setting, and 60.4% (55/91) were women. Seven patients had minor immediate complications related to the radial access. Interventional procedures successfully performed included aneurysm embolization (ruptured (n=3) and unruptured (n=8)), tumor embolization (n=2), cervical internal carotid artery stenting (n=2), balloon occlusion test (n=1), vertebral artery sacrifice (n=1), and arteriovenous malformation embolization (n=2).

Conclusion In this early experience, full transition to the transradial approach as the frontline approach is feasible with a low complication rate for both diagnostic and interventional neuroendovascular procedures.

  • angiography
  • catheter
  • device
  • guidewire
  • technique

http://dx.doi.org/10.1136/neurintsurg-2019-015127

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    Footnotes

    • Contributors All authors have provided a substantial contribution to the conception and design of the studies ‎and/or the acquisition and/or the analysis of the data and/or the interpretation of the data. ‎They have drafted the work or revised it for significant intellectual content and approved the ‎final version of the manuscript. They agree to be accountable for all aspects of the work, ‎including its accuracy and integrity.‎

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Disclaimer The authors confirm that the study is an observational minimal risk study and no consent is required per the Medical University of South Carolina institute policy. Our study was approved by the institutional review board of the Medical University of South Carolina.

    • Competing interests AS: Penumbra consulting, Minnetronix consulting, Cerenovus consulting.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Additional data from this project can be acquired by contacting the ‎corresponding author.‎

    • Patient consent for publication Not required.