Distal radial approach for neurointerventional diagnosis and therapy

Goland, Javier; Domitrovic, Luis; Doroszuk, Gustavo; Garbugino, Silvia; Ypa, Paula

doi:10.25259/sni_410_2019

Cited by 18 publications

(18 citation statements)

References 11 publications

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“…[2][3][4]9 In previous four reports of neurointervention, 5-6 Fr introducer sheaths were used. [12][13][14][15] A prospective study showed an association between the size mismatch of the radial artery and introducer sheath for radial artery occlusion after TRA. When the ratio of the inner diameter of the radial artery and the outer diameter of the introducer sheath is less than one, the risk of radial artery occlusion is much higher (48.7%).…”

Section: Discussionmentioning

confidence: 99%

Safety and feasibility of the distal transradial approach: A novel technique for diagnostic cerebral angiography

et al. 2020

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Purpose We aimed to evaluate the safety and feasibility of the distal transradial approach (DTRA) as a novel technique for cerebral angiography based on our institutional initial experience. Methods We retrospectively analyzed our institutional database of consecutive diagnostic cerebral angiographies performed with DTRA from December 2018 to August 2019. Patient demographics and clinical and procedural data were recorded. Results In total, 51 diagnostic cerebral angiographies in 51 patients (age, 15–83 years; mean age, 59.4 years, SD 13.5; 35 (69%) females) were performed or attempted with DTRA. Ultrasound evaluation showed that the mean inner distal radial artery diameter was significantly smaller than the mean inner forearm radial artery diameter (2.19 mm vs. 2.56 mm, P < 0.001). Cannulation via the distal radial artery was successful in 47 (92%) procedures. In the four procedures that failed, operators converted to the ipsilateral transradial approach without repositioning or redraping. Selective catheterization of the intended vessel was achieved in 64 (91%) of 70 vessels. In the remaining six, operators achieved the objective of the examination with angiography injecting from proximal and conversion to another approach was not required. One patient experienced temporary numbness around the puncture site after the procedure. No radial artery occlusion was identified in the patients who underwent ultrasound evaluation. Conclusion Our results demonstrate that DTRA could become a standard approach for diagnostic cerebral angiography owing to the low complication rate and the high cannulation success rate.

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Section: Discussionmentioning

confidence: 99%

Safety and feasibility of the distal transradial approach: A novel technique for diagnostic cerebral angiography

et al. 2020

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“…There are reports of diagnostic and therapeutic procedures performed through a variation of the TRA, accessing a more distal radial segment at the anatomical snuffbox; this is variably known as the dTRA, snuffbox approach, or very dTRA. [ 9 , 26 , 56 , 65 ] The radial artery is punctured between the tendon of the extensor pollicis longus and tendons of the extensor pollicis brevis and abductor pollicis longus. The dTRA approach has some benefits, relative to the conventional radial approach.…”

Section: Techniquementioning

confidence: 99%

“…In our experience, we have observed a reduced number of femoral-approach procedures when the dTRA is implemented as as an approach option. [ 26 ]…”

Section: Techniquementioning

confidence: 99%

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Transradial approach and its variations for neurointerventional procedures: Literature review

Zalocar

Doroszuk

Goland

2020

Surgical Neurology International

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Background: The transfemoral approach (TFA) has been the standard in neuroradiology over the years. However, the transradial approach (TRA) and its variants offer several benefits over the TFA. Methods: Review of the literature about TRA and its variations. We present our results for different neurointerventional procedures at our institution between January 2018 and December 2019. Results: We wrote an educational review describing anatomical and technical aspects, advantages, and complications of this approach. In the past year we increased the percentage of neurointerventional procedures performed through radial or ulnar arteries. Conclusion: There are clearly proven benefits of employing a wrist approach in patients for neurointerventional procedures and its utilization should especially be considered on a daily basis.

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“…[ 9 , 10 ] There is a variant of the transradial approach, called the distal radial approach, which yields the same results through more distal puncture of the radial artery. [ 8 ]…”

Section: Introductionmentioning

confidence: 99%

Outpatient treatment of cerebral aneurysms: A case series

Goland

Doroszuk

Ypa

et al. 2020

Surgical Neurology International

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Background: Major advances in the endovascular treatment of cerebral aneurysms have reduced the incidence of intra- and postprocedural complications. The length of stay after treatment for incidental aneurysms remains between early next-day discharge and 2 days. We hypothesized that discharging patients the same day would not be associated with any increase in the rate of postdischarge adverse events. Methods: We retrospectively reviewed the charts of patients who underwent an elective coiling procedure between 2015 and 2020 at three centers and were discharged from hospital on the same day as the procedure. Patients were clinically evaluated 6 h, 1 week, and 6 months after the procedure, with repeat cerebral angiography performed 1 year after the procedure. Results: Eleven eligible patients underwent outpatient treatment of 12 aneurysms treated through the wrist. No complications were identified within 1 week of the procedure. Clinical evaluation 6 months after treatment also failed to reveal any complication associated with the procedure. Only one of the seven patients who underwent 1 year angiography required retreatment. Conclusion: It is possible to safely perform coiled embolization of cerebral aneurysms in select outpatients with unruptured cerebral aneurysms.

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Distal radial approach for neurointerventional diagnosis and therapy

Cited by 18 publications

References 11 publications

Safety and feasibility of the distal transradial approach: A novel technique for diagnostic cerebral angiography

Safety and feasibility of the distal transradial approach: A novel technique for diagnostic cerebral angiography

Transradial approach and its variations for neurointerventional procedures: Literature review

Outpatient treatment of cerebral aneurysms: A case series

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