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  • Use of the Simmons guiding sheath via left transradial access as a feasible strategy for neurointerventions in patients with an aberrant right subclavian artery

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Letter
Use of the Simmons guiding sheath via left transradial access as a feasible strategy for neurointerventions in patients with an aberrant right subclavian artery
  1. Yoshiki Hanaoka1,
  2. Yuki Inomata1,
  3. Jun-ichi Koyama2,
  4. Takuya Nakamura1,
  5. Satoshi Kitamura2,
  6. Daisuke Yamazaki1,
  7. Tetsuyoshi Horiuchi1
  1. 1 Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
  2. 2 Neuroendovascular Therapy Center, Shinshu University Hospital, Matsumoto, Nagano, Japan
  1. Correspondence to Dr Yoshiki Hanaoka, Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan; hanaoka{at}shinshu-u.ac.jp

http://dx.doi.org/10.1136/jnis-2023-020539

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    We read with interest the paper ‘Transradial flow diversion with an aberrant right subclavian artery’ by Bram et al.1 The authors presented the case of a patient with an aberrant right subclavian artery (ARSA) who underwent flow diversion for a small left internal carotid artery (ICA) aneurysm via a right transradial access (TRA). Under general anesthesia, a 6F Slender sheath (Terumo, Tokyo, Japan) was introduced via the right TRA, and a Simmons-2 catheter was delivered into the right subclavian artery. Despite attempts to reshape the Simmons-2 curve, the procedure failed because it prolapsed into the descending aorta. The patient was found to have an ARSA. Subsequently, a Simmons-1 catheter was easily navigated from the ARSA ostium toward the aortic valve owing to its shape. After shaping a guidewire by bouncing it off the aortic valve, …

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    Footnotes

    • Contributors YH: conception and design of the work, data collection and interpretation, drafting of the article, final approval of the version to be published. YI, JK, TN, SK, DY, TH: data interpretation and critically revising of the article, final approval of the version to be published.

    • 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.

    • Competing interests None declared.

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

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