Introduction Transradial access (TRA) has slowly gained momentum within the neurointerventional community regarding cerebral angiography and neurointervention. In the recent years, we are seeing more neurointerventional literature showing evidence of the safety and efficacy of using TRA compared to transfemoral (TFA). Radial access is not without limitations including smaller artery size, anatomical variants and lack of radial-specific catheters.

Aim of Study To primary aim is to demonstrate the safety and efficacy of intracranial aneurysm treatment with flow diverting stents in patients on dual antiplatelets using transradial compared with transfemoral access

Methods We conducted a retrospective 140 consecutive patients who underwent endovascular embolization for intracranial aneurysms using flow diverting stents from January 2019 through January 2023. Patients were divided into two groups: transradial access (63 patients) and TFA (77 patients). A comparative analysis was performed between the two groups.

Results There was no significant difference in postoperative ICH, ischemic stroke, or other complications between TRA versus TFA groups. However, access site complications were lower in TRA versus TFA group (4.7 vs. 12.9%, respectively), pridominantly in the form of superficial haematoma. There was no significant difference in complete aneurysm occlusion at 6 and 24 month follow-up DSA or MRA.

Conclusion The efficacy of flow diversion via TRA for the treatment of intracranial aneurysms is comparable to TFA. However, access site complications were significantly lower in TRA group. Whenever feasible, adoption of radial approach should be considered in neurointervetional procedures, particularly when dual antiplatelet therapy is used.

Disclosure of Interest no.