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Pearls and Pitfalls of the Transradial Approach for Neurointerventions: Lessons Learned after 760 Procedures
Ist Teil von
Neurosurgery, 2020-12, Vol.67 (Supplement_1)
Ort / Verlag
Oxford: Oxford University Press
Erscheinungsjahr
2020
Link zum Volltext
Quelle
Oxford Journals 2020 Medicine
Beschreibungen/Notizen
INTRODUCTION The radial approach has been gaining more widespread use by neurointerventionalists fueled by data from the cardiology literature showing better safety and overall reduced morbidity. METHODS We conducted a retrospective analysis and identified neuroendovascular procedures performed via the upper extremity vasculature access site. RESULTS Amongst 760 procedures, 34.2% were therapeutic, and 65.7% were non-therapeutic angiograms. Access sites were 71.5% via a conventional radial artery, 27.8% via a distal radial artery, 0.5% via a ulnar artery, and 0.1% via the brachial artery. Most of the procedures were performed via the right side, 96.9%, 2.9% via the left-sided, and 0.1% via a bilateral approach. Major access site complications occurred at a rate of 0.9%. The rate of transfemoral conversion was 4.7%. There was no significant difference in procedural metrics between patients who underwent one, two, three, or four procedures. There was a statistically higher incidence of transfemoral conversion when repeat procedures were performed using the same access site. Also, there was no significant difference between non-therapeutic procedures performed using the right and left radial access, and conventional versus distal radial access. CONCLUSION Radial artery catheterization is a safe and effective means of carrying out a wide-range of neuroendovascular procedures associated with excellent clinical outcomes and an overall low rate of periprocedural complications.