Anatomic Snuffbox (Distal Radial Artery) and Radial Artery Access for Treatment of Intracranial Aneurysms with FDA-Approved Flow Diverters
| Autor: | K de Macedo Rodrigues, J Singh, Sudhakar R Satti, Matthew J. Gounis, Anna Luisa Kühn, Francesco Massari, T Eden, Ajit S. Puri |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Catheters Radiography medicine.medical_treatment Femoral artery Asymptomatic 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Aneurysm medicine.artery Occlusion medicine Humans Radiology Nuclear Medicine and imaging Embolization Radial artery Aged Retrospective Studies Flow diverter Interventional business.industry Endovascular Procedures Intracranial Aneurysm Middle Aged medicine.disease Embolization Therapeutic Blood Vessel Prosthesis Surgery Femoral Artery Treatment Outcome Radial Artery Female Neurology (clinical) medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | AJNR Am J Neuroradiol |
| ISSN: | 1936-959X 0195-6108 |
| Popis: | BACKGROUND AND PURPOSE: Transradial access for neurointerventional procedures has been proved a safer and more comfortable alternative to femoral artery access. We present our experience with transradial (distal radial/anatomic snuffbox and radial artery) access for treatment of intracranial aneurysms using all 3 FDA-approved flow diverters. MATERIALS AND METHODS: This was a high-volume, dual-center, retrospective analysis of each institution’s data base between June 2018 and June 2020 and a collection of all patients treated with flow diversion via transradial access. Patient demographic information and procedural and radiographic data were obtained. RESULTS: Seventy-four patients were identified (64 female patients) with a mean age of 57.5 years with a total of 86 aneurysms. Most aneurysms were located in the anterior circulation (93%) and within the intracranial ICA (67.4%). The mean aneurysm size was 5.5 mm. Flow diverters placed included the Pipeline Embolization Device (Flex) (PED, n = 65), the Surpass Streamline Flow Diverter (n = 8), and the Flow-Redirection Endoluminal Device (FRED, n = 1). Transradial access was successful in all cases, but femoral crossover was required in 3 cases (4.1%) due to tortuous anatomy and inadequate support of the catheters in 2 cases and an inability to navigate to the target vessel in a patient with an aberrant right subclavian artery. All 71 other interventions were successfully performed via the transradial approach (95.9%). No access site complications were encountered. Asymptomatic radial artery occlusion was encountered in 1 case (3.7%). CONCLUSIONS: Flow diverters can be successfully placed via the transradial approach with high technical success, low access site complications, and a low femoral crossover rate. |
| Databáze: | OpenAIRE |
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