Radial artery neuro guide catheter entrapment during mechanical thrombectomy for acute ischemic stroke: Rescue brachial plexus block

Satti, Sudhakar R; Sivapatham, Thinesh; Eden, Timothy J.

doi:10.1177/1591019920950889

Cited by 7 publications

(3 citation statements)

References 8 publications

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“…8 F neuro long guide sheaths have an outer diameter of approximately 2.8 mm, which is larger than the average radial artery diameter in a significant proportion of patients. 17 When the diameter of the radial artery was less then 2.5 mm, Benchmark guiding catheter instead of a larger bore guiding catheter was used. Stampfli et al performed LVOs MT with 5F SOFIA in 115 cases.…”

Section: Discussionmentioning

confidence: 99%

5F SOFIA intermediate catheter in the treatment of acute ischemic stroke: A retrospective observational study

et al. 2022

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Background We herein report our experience with the 5F SOFIA (Soft Torqueable catheter Optimized for Intracranial Access) intermediate catheter for endovascular treatment of patients with acute ischemic stroke (AIS) both in distal middle vessel occlusions (DMVOs) and in large vessel occlusions (LVOs) with unfavorable anatomy. Methods Records of forty-seven patients undergoing endovascular thrombectomy with 5F SOFIA between September 2020 and March 2022 were retrospectively reviewed. Patients’ demographic data, clinical presentation, treatment details, and complications were recorded from the medical record. The primary outcomes were successful revascularization (modified treatment in cerebral ischemia, mTICI ≥2b) and good clinical outcome at 3 months (modified rankin scale, mRS 0-2). Secondary outcomes were complication rates and switch to alternative techniques. Our institutional review board approved this study. Results Forty-seven patients with AIS treated with 5F SOFIA were examined. In eighteen (38%) cases the occlusion was located on a large vessel while in 29 (61.7%) on a distal-medium vessels. Median national institutes of health strokes scale (NIHSS) score was 16 at admission. Successful revascularization to mTICI 2b-3 was achieved in 14 of 18 patients (77.7%) with LVOs and in 24/29 cases with DMVOs (82.7%) respectively. mRS score 0-2 at three months (3 months-mRS 0-2) was 66.6% for LVOs and 68.9% in DMVOs respectively. Symptomatic intracranial hemorrhage (SICH) occurred in 2 (4.2%) patients. Conclusion 5F SOFIA intermediate catheter could be a safe and effective treatment for AIS and a viable alternative to 6 F conventional intermediate catheters in selected cases.

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Section: Discussionmentioning

confidence: 99%

5F SOFIA intermediate catheter in the treatment of acute ischemic stroke: A retrospective observational study

et al. 2022

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“…16 Importantly, we had no cases of catheter entrapment in the radial artery, a complication that has been reported with other ACs. 17 Lin et al described using a 0.088 ′′ ID AC, via a femoral approach, for flow diversion and treatment of intracranial aneurysm; they reported an access site complication rate of 1.1% (1/95; groin hematoma) and a 1.1% (1/95) rate of carotid dissection. 9 Likewise, Bageac et al reported their experience in 42 patients with using a new 0.088 ′′ ID AC, via a femoral approach, for flow diversion; they reported a dissection rate of 2.3% (1/44 interventions).…”

Section: Advantages Of the Bmx96mentioning

confidence: 99%

Initial experience of using a large-bore (0.096″ inner diameter) access catheter in neurovascular interventions

et al. 2022

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Introduction The purpose of this study was to report our initial experience of using a large-bore (0.096″ inner diameter) access catheter in neurovascular interventions. Methods Data were retrospectively collected from 5 sites in the US for neurovascular procedures performed using a large-bore access catheter. The effectiveness outcome was technical success, defined as the access catheter's successfully reaching its target vessel without conversion to direct carotid puncture or to a smaller-bore access catheter and successfully completing the intended neurointervention. Results One hundred and thirteen procedures performed in 112 patients were included in this study. The mean age of the patients was 67.5 years (SD 16.2), and about half (49.1%) were female. The most common primary access sites were the femoral (64.6%) or radial (32.7%) artery. Challenging anatomic variations included severe vessel tortuosity (26/81, 32.1%), type II aortic arch (17/88, 19.3%), type III aortic arch (14/88, 15.9%), bovine arch (16/104, 15.4%), severe angle (<30°) between the subclavian and target vessel (11/74, 14.9%), and subclavian loop (7/79, 8.9%). The median access time to branch view was 18 min (IQR 11-28, N = 75). The technical success rate was 94.7%. Two dissections (1.8%) were related to the large-bore access catheter. Access site complications occurred in 2 patients (1.8%). Four additional symptomatic periprocedural complications not related to the large-bore access catheter occurred (7.1%). Conclusion For neurovascular interventions, a 0.096″ inner diameter access catheter could be used with both femoral and radial arterial approaches, had a high technical success rate, and had a low rate of periprocedural complications.

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“…In complex epiaortic vessel anatomy (e.g., bovine arch, type III aortic arch, extracranial tortuosity/kinking/loop), TRA catheterization is expected to be much less time-consuming than the TFA approach. As for today, the critical drawback of TRA-MT is the forced choice between either sheathless 8F guide catheters, designed for femoral approach and carrying a higher risk of spasm/catheter entrapment [ 2 ], or 6F low-profile sheath and 6F guide catheters, with a significant downsizing of the aspiration catheter diameter [ 3 ]. Shortly after the new RED aspiration catheter family from Penumbra came to market in late 2022, it was noted that the thinnest one (RED 62) was fully compatible with a 7F guide catheter (e.g., Rist; Medtronic or Fubuki; Asahi Intecc Co., Ltd.).…”

Section: Introductionmentioning

confidence: 99%

A “Radial Ready” Tricoaxial Setup for Anterior Circulation Mechanical Thrombectomy: Technical Aspects and Preliminary Results

Molinaro,

Russo,

Mistretta

et al. 2024

Neurointervention

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Purpose: Mechanical thrombectomy (MT) is the standard of care for acute ischemic stroke (AIS) due to large vessel occlusion (LVO). The choice of a transradial approach (TRA) for anterior circulation LVOs is still debatable; the use of a specific tricoaxial system could help mitigate numerous issues related to transradial MT.Materials and Methods: From November 2022 to November 2023, 22 patients underwent TRA-MT for anterior circulation LVOs, both as first-line and rescue from transfemoral approach (TFA) failure, with the same triaxial setup consisting of a 7F introducer sheath, 7F guide catheter, and aspiration catheters ranging from 5.5F to 5F in relation to the occlusion site. Choice of thrombectomy technique was at operator discretion. Patients’ demographic data, clinical presentation, treatment details, complications, rate of crossover to TFA, successful revascularization (modified thrombolysis in cerebral infarction [mTICI] score ≥2b), and good clinical outcome at 3 months (modified Rankin scale [mRS] 0-2) were reported.Results: Of 20 patients selected, 10 (50%) had occlusion of M1 segment of middle cerebral artery (MCA), 6 (30%) of internal carotid artery (ICA) terminus, and 4 (20%) with M2 MCA occlusions; 12/20 (60%) were right-sided occlusions and 8/20 (40%) were left-sided. The mean National Institutes of Health Stroke Scale score was 9.25 at admission. Successful revascularization to mTICI 2b-3 was achieved in 18/20 patients (90%). Intracranial complications were reported in 2 (10%) patients. Rate of radial artery occlusion at 24 hours was 10,6%; no access-site haemorrhagic complications were reported. Symptomatic intracranial hemorrhage occurred in 2 (10%) patients. mRS score 0-2 at 3 months was 50%.Conclusion: The high technical effectiveness and good safety profile of this specific tricoaxial setup for TRA-MT in AIS, even for large proximal LVOs, could constitute a viable alternative to TFA-MT in selected cases.

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Radial artery neuro guide catheter entrapment during mechanical thrombectomy for acute ischemic stroke: Rescue brachial plexus block

Cited by 7 publications

References 8 publications

5F SOFIA intermediate catheter in the treatment of acute ischemic stroke: A retrospective observational study

5F SOFIA intermediate catheter in the treatment of acute ischemic stroke: A retrospective observational study

Initial experience of using a large-bore (0.096″ inner diameter) access catheter in neurovascular interventions

A “Radial Ready” Tricoaxial Setup for Anterior Circulation Mechanical Thrombectomy: Technical Aspects and Preliminary Results

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