Transradial approach to treating endovascular cerebral aneurysms: Case series and technical note

Abstract

Background:Several benefits have been described over the years of the transradial versus femoral endovascular approach to cardiac interventions. Consequently, its use has become habitual at most centers that perform cardiac catheterizations. This paper details a right transradial approach, incorporating a variety of coils or flow diverters, which can be utilized for the endovascular treatment of different cerebral aneurysms.Methods:From 2014 to 2016, we performed 40 endovascular procedures to treat cerebral aneurysms adopting the same right transradial approach. Five aneurysms were treated with flow diverters and 35 were treated with coils. Seven of these aneurisms were asymptomatic, whereas 33 had already ruptured.Results:Satisfactory treatment was achieved in all cases through the same approach in the absence of any complications.Conclusions:A right transradial approach may be satisfactory for the endovascular treatment of different cerebral aneurysms, including aneurysms in either hemisphere. This is the largest series of cerebral aneurysms treated through a transradial approach.

Transradial approach for neurointerventions: a systematic review of the literature

“…The location of the lesion was described as an anterior or posterior circulation lesion in 955 cases, of which 816 (85.44%) were located in the anterior circulation and 121 (14.55%) were located in the posterior circulation. The studies included are described in table 1 7–27…”

Cerebral Angiography in lateral decubitus

“…Transradial approach for cerebral angiography has been described in multiple studies and is the first choice of approach of cerebral angiography in our department because of the increased comfort reported by patients, decreased stay time and complications associated with it. 6 The technique used was described in other articles and is not part of the interest of this presentation. 8,9 This case presents the particularity of a patient presenting with profuse bleeding in supine decubitus.…”

“…2,3 This approach is associated with a lower incidence of complications associated with puncture, more comfort for patients and shorter time of stay after the study. [4][5][6] Alternative approaches to femoral puncture are brachial, cervical carotid andradial approaches. 7 Radial approach is the only one that allows the study in a different position to supine.…”

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

“…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.…”