Introduction More than ten years of experience as reported by interventional cardiologists has demonstrated several advantages of transradial access (TRA). The decreased risk of access site haemorrhagic complications is particularly relevant for mechanical thrombectomy (MT). This alternative approach should be explored in greater detail, as questions regarding feasibility and safety still exist among interventional neuroradiologists.
Aim of Study To present our single institution experience considering the feasibility, complications, and technical features of TRA.
Methods Retrospective review of MT performed via TRA between May 2021 and February 2023.
Results A total of 17 patients were identified (female 10, male 7, mean age of 79,25 years). Of the 17 TRA performed, 15 were conducted after transfemoral access (TFA) failure and 2 were performed as the primary approach. Right-sided TRA was obtained in all cases. Successful revascularization (Thrombolysis in Cerebral Infarction score ≥2b) was obtained in 9 cases. The single-pass recanalization rate was 44% and the average number of passes was 1,87. No major radial artery complications were recorded, except for one case of artery rupture, that was well-managed with manual compression. Anatomical variant with bovine aortic arch was present in two patients. The main cause for TRA failure was small radial artery diameter.
Conclusion These results suggest that TRA is a viable alternative to TFA. In addition to the decreased incidence of haemorrhagic complications, TRA may also be particularly useful for stroke patients whose vascular anatomy presents a challenge for TFA (e.g., bovine aortic arch configuration and marked supra-aortic branch tortuosity).
Disclosure of Interest Nothing to disclose.
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