Transradial Access or Simmons Shaped 8F Guide Enables Delivery of Flow Diverters in Patients With Large Intracranial Aneurysms and Type III Aortic Arch

Dietrich, Carolin; Hauck, Gesa H; Valvassori, Luca; Hauck, Erik F.

doi:10.1227/neu.0b013e31827e0d67

Cited by 8 publications

(15 citation statements)

References 20 publications

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“…Previous reports on the transradial approach described the use of TRA flow diversion for type III aortic arch, right-sided target vessels, which are difficult to access through the transfemoral approach. 16,17 These reports described the use of a triaxial catheter system via a transradial approach. In the current series, we have demonstrated the feasibility of the transradial approach for both right ( n = 19) and left-sided ( n = 14) target vessels.…”

Section: Discussionmentioning

confidence: 99%

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Transradial access for flow diversion of intracranial aneurysms: Case series

et al. 2020

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Background Transradial access for neurointerventions offers advantages of fewer access-site complications, reduced procedure time, and greater patient comfort over transfemoral access. Data about transradial access for flow diversion are limited. We share our early experience with transradial access for flow diversion in a relatively large case series. Methods Consecutive patients who underwent Pipeline embolization device (Medtronic) deployment via transradial access were included in the study, irrespective of location and laterality of the intracranial aneurysm. The cases were performed between July 2016 and October 2019. Demographics, aneurysm characteristics, and procedure-related details (including catheter systems used) were recorded and statistically evaluated. Results Thirty-five transradial flow diversion procedures were attempted in 32 patients, of which 33 procedures were successful. In two cases involving left common carotid artery and internal carotid artery access, guide catheter herniation into the aortic arch led to abandonment of transradial access in favor of transfemoral access. The most common aneurysm locations in the transradial access procedures were the posterior communicating artery ( n = 7), ophthalmic artery ( n = 7), and superior hypophyseal artery ( n = 7). Most transradial access procedures (66.7%) were performed using a biaxial catheter system. 6-French Benchmark (Penumbra) and Phenom 27 (Medtronic) were the most commonly utilized guide- and microcatheters, respectively. One patient had intraprocedural subarachnoid hemorrhage. No access-site complications occurred. Conclusion This study demonstrates safety and feasibility of transradial access for Pipeline embolization device deployment and shows the versatility of this approach for different catheter systems. Tortuosity and acute angulation of the left common carotid artery and internal carotid artery were associated with approach failure.

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Section: Discussionmentioning

confidence: 99%

“…Previous studies describing transradial flow diversion are summarized in Table 3. 13,16–19 It is important to note that in all studies, the cases where transradial flow diversion was unsuccessful involved the left CCA and ICA.…”

Section: Discussionmentioning

confidence: 99%

Transradial access for flow diversion of intracranial aneurysms: Case series

et al. 2020

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“…Multiple large retrospective single center series have demonstrated the safety and efficacy of transradial cerebral angiography 21–27. In addition, complex interventions for both ischemic and hemorrhagic disease of the posterior and anterior circulation have been reported, highlighting the feasibility of this approach despite the use of femoral designed devices 11 28–35. Furthermore, the best practices of TRA and closure have been extensively studied in the cardiology literature, as the reduction in access site complications from TRA has driven conversion worldwide among cardiologists 36.…”

Section: Transradial Arterial Accessmentioning

confidence: 99%

Transarterial and transvenous access for neurointerventional surgery: report of the SNIS Standards and Guidelines Committee

Starke

Snelling

Al‐Mufti

et al. 2019

J NeuroIntervent Surg

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The purpose of this publication is to provide a comprehensive review on the techniques and tools used for vascular access in neurointerventional procedures. Using published literature, we reviewed data on access methods, sites, tools, and techniques for neurointerventions. Recommendations are provided based on quality of data/levels of evidence and, where appropriate, expert consensus. While tools and techniques continue to be developed, current literature and experience supports certain principles regarding vascular access for neurointerventional procedures.

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“…Первые публикации о возможности применения трансрадиального доступа в хирургии патологии внутричерепных сосудов принадлежат E. Eskioglu и соавт. (2004) [14] [4]. Появляются публикации о применении трансрадиального доступа для выполнения механической тромбэкстракции при лечении пациентов с острым ишемическим инсультом [15][16].…”

Section: случай из практикиunclassified

“…Применение данных доступов позволяет добиться аналогичных результатов при меньшей частоте местных осложнений и большем комфорте для пациента [1]. Однако в литературе описаны немногочисленные случаи применения трансрадиального артериального доступа для выполнения оперативного вмешательства при патологии сосудов головного мозга [1][2][3][4][5]. В данной статье мы приводим пример успешного применения трансрадиального доступа при эмболизации аневризмы бифуркации базилярной артерии в условиях стент-ассистенции, а также обзор литературы, посвященный применению трансрадиального доступа в хирургии сосудов головного мозга.…”

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Transradial approach to embolization of a basilar aneurysm: a clinical case and literature review

Kandyba

Бабичев

Zenin

2019

Nejrohirurgiâ (Mosk.)

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The study objective is to present a clinical case of using transradial access for embolization of an aneurysm of the basilar artery (BA) bifurcation. Materials and methods. A patient, 67 years old, sought medical help at the I.I. Dzhanelidze Saint Petersburg Research Institute of Emergency Medicine complaining of headaches. Computed angiography of the brain had shown a large aneurysm of the BA with an absolutely wide neck. Embolization of the aneurysm using stent assistance (Y-stenting) was performed with access through the radial artery. The results were compared to data from scientific literature (about 16 cases).Results. Aneurysm embolization level was II or IIIb per the modified Raymond–Roy classification was performed. No complications were observed, blood flow in the radial artery was preserved. The patient was released on day 2 after the surgery. No signs of blood flow through the aneurysm were observed during control selective cerebral angiography 12 months later. According to literature data, transradial access is preferable only with pathology of the vertebrobasilar system, especially if standard access is impossible to form due to atherosclerotic damage of the femoral artery, angling of the aortic arch, and pathological vessel tortuosity.Conclusion. Routine use of transradial access in surgery of pathologies of the cerebral flow is not justifiable. But in some cases, this alternative access can be more effective and safer compared to the standard access. The main advantages of this access are reduced rate of complications of arterial access and possibility of early patient activization.

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Transradial Access or Simmons Shaped 8F Guide Enables Delivery of Flow Diverters in Patients With Large Intracranial Aneurysms and Type III Aortic Arch

Abstract: Transradial access or guide support with the 8F Simmons II catheter grants stable access for curative embolization with the PED in elderly patients with a large intracranial aneurysm and a complex aortic arch.

Cited by 8 publications

References 20 publications

Transradial access for flow diversion of intracranial aneurysms: Case series

Transradial access for flow diversion of intracranial aneurysms: Case series

Transarterial and transvenous access for neurointerventional surgery: report of the SNIS Standards and Guidelines Committee

Transradial approach to embolization of a basilar aneurysm: a clinical case and literature review

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