Background There is little consensus on endovascular treatment for symptomatic intracranial posterior circulation stenosis via the transradial approach (TRA). We report our multicenter experience and technical procedures that directly used a distal access catheter (DAC) via TRA for the treatment of symptomatic intracranial vertebral (VA) and basilar (BA) artery stenosis.
Methods From January 2019 to December 2020, 92 consecutive patients with severe symptomatic intracranial VA or BA stenosis were retrospectively collected and divided into two groups (TRA group and transfemoral approach (TFA) group) for neurointerventional treatment. The percentages of catheters reaching the V3/V4 segment of the VA and technical success, postoperative care conditions, preoperative outcomes and complications, long term clinical outcomes, and imaging follow-ups were observed.
Results The catheter, CAT 5, reached the V4 segment of the VA in 37 TRA patients (88.1%). The duration of the procedure was significantly shorter in the TRA group than in the TFA group (median 48.0 min vs 55.5 min, p=0.037). More patients in the TRA group could walk within 2 hours after the procedure (85.7% vs 10.0%, p=0.000), and the duration of retaining catheterization in the TRA group was shorter (3.0±1.2 hours vs 11.7±5.6 hours, p=0.000).
Conclusion This study demonstrates the potential feasibility and safety of using a DAC via the TRA without guiding support for the treatment of symptomatic intracranial VA and BA stenosis. The TRA demonstrated some advantages over the standard TFA in terms of patient comfort. Further randomized controlled trials comparing the TRA and TFA for posterior circulation stenosis are needed.
Data availability statement
All data relevant to the study are included in the article or uploaded as supplemental information. All data supporting the study results are included in the article.
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XG and LW contributed equally.
Contributors XG: study design, literature search, data collection and database establishment, statistical analysis, and chief writer of the manuscript. LW, JL, YM, CF, and NZ: literature search and data collection. LY: data collection and statistical analysis. LS: data collection, manuscript reviewing and modification, and data analysis. ZM: study design, chief writer and revised the manuscript, and guarantor.
Funding This study was supported by the National Key Research and Development Program of China (2016 YFC1301500).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.