Retained radial catheters associated with variant radial anatomy in neurointerventional procedures.

Autor:	Catapano JS; Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA., Winkler EA; Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA., Srinivasan VM; Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA., Dishion EL; Department of Neurology, Barrow Neurological Institute, Phoenix, Arizona, USA., Rutledge C; Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA., Baranoski JF; Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA., Cole TS; Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA., Rudy RF; Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA., Rumalla K; Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA., Zomaya MP; The University of Arizona College of Medicine Phoenix, Phoenix, Arizona, USA., Jadhav AP; Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA., Ducruet AF; Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA., Albuquerque FC; Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA Neuropub@Barrowneuro.org.
Jazyk:	angličtina
Zdroj:	Journal of neurointerventional surgery [J Neurointerv Surg] 2023 Sep; Vol. 15 (9), pp. 858-863. Date of Electronic Publication: 2022 Sep 09.
DOI:	10.1136/jnis-2022-019004
Abstrakt:	Background: Transradial artery access (TRA) for neurointerventional procedures is gaining widespread acceptance. However, complications that were previously rare may arise as TRA procedures increase. Here we report a series of retained catheter cases with a literature review. Methods: All patients who underwent a neurointerventional procedure during a 23-month period at a single institution were retrospectively reviewed for a retained catheter in TRA cases. In cases of retained catheters, imaging was reviewed for anatomical variances in the radial artery, and clinical and demographic case details were analyzed. Results: A total of 1386 nondiagnostic neurointerventional procedures were performed during the study period, 631 (46%) initially via TRA. The 631 TRA cases were performed for aneurysm embolization (n=221, 35%), mechanical thrombectomy (n=116, 18%), carotid stent/angioplasty (n=40, 6%), arteriovenous malformation embolization (n=38, 6%), and other reasons (n=216, 34%). Thirty-nine (6%) TRA procedures crossed over to femoral access, most commonly because the artery of interest could not be catheterized (26/39, 67%). A retained catheter was identified in five cases (1%), and one (0.2%) patient had an entrapped catheter that was recovered. All six patients with a retained or entrapped catheter had aberrant radial anatomy. Conclusion: Retained catheters for neurointerventional procedures performed via TRA are rare. However, this complication may be associated with variant radial anatomy. With the increased use of TRA for neurointerventional procedures, awareness of anatomical abnormalities that may lead to a retained catheter is necessary. We propose a simple protocol to avoid catheter entrapment, including in emergent situations such as TRA for stroke thrombectomy. Competing Interests: Competing interests: FCA and AFD serve on the editorial board of the Journal of NeuroInterventional Surgery. (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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