1
|
Quinn C, Masood K, Mehta T, Topiwala K, Grande A, Tummala R, Jagadeesan BD. Trans-radial spinal angiography: A single-center experience. Interv Neuroradiol 2024; 30:288-292. [PMID: 36299241 PMCID: PMC11095346 DOI: 10.1177/15910199221135052] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 10/05/2022] [Indexed: 02/18/2024] Open
Abstract
INTRODUCTION Spinal angiography (SpAn) is the gold standard for diagnosis of spinal dural fistulas and arteriovenous malformations. A complete spinal angiogram necessitates the interrogation of the segmental arteries arising from the aorta at every level as well, the internal iliac; and median sacral arteries at the caudal end; and the cervical vasculature at the cranial end. SpAn has traditionally been performed with transfemoral arterial access and could be challenging. Of late, transradial arterial access has emerged as a popular alternative for endovascular surgical Neuroradiology (ESN) procedures including SpAn. However, there is paucity of the literature regarding transradial access for spinal angiography. METHODS After IRB approval, records and imaging were reviewed in a series of patients who underwent SpAn at our institution. RESULTS A total of nine spinal angiograms were performed via transradial access in a consecutive series of eight patients between July 2019 and December 2020 at our institution. Eight of these were diagnostic SpAn's, and one patient underwent SpAn with transradial approach for the treatment of a type I spinal dural arteriovenous fistula. No complications occurred during or subsequent to the procedures. CONCLUSION SpAn can be successfully and safely accomplished via transradial access. This approach appears to provide a stable method for interventions, as well.
Collapse
Affiliation(s)
- Coridon Quinn
- Department of Neurosurgery, University of Minnesota, Minneapolis, MN, USA
| | - Kamran Masood
- Department of Radiology, University of Minnesota, Minneapolis, MN, USA
| | - Tapan Mehta
- Hartford HealthCare Medical Group, Interventional Neuroradiology, Hartford, CT, USA
| | - Karan Topiwala
- Department of Neurology, University of Minnesota, Minneapolis, MN, USA
| | - Andrew Grande
- Department of Neurosurgery, University of Minnesota, Minneapolis, MN, USA
| | | | | |
Collapse
|
2
|
Bhatia V, Kumar A, Chauhan R, Singla N. Transradial approach in neurointervention: Part-II: Diagnostic and therapeutic intervention. J Neurosci Rural Pract 2023; 14:16-20. [PMID: 36891109 PMCID: PMC9945293 DOI: 10.25259/jnrp-2022-5-27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 09/22/2022] [Indexed: 12/14/2022] Open
Abstract
Recent studies and meta-analysis have shown the safety, feasibility, and success of the transradial approach in diagnostic and therapeutic neurointervention. This second part of the review focuses on the technical aspects of diagnostic and therapeutic neurointervention after the radial sheath has been placed.
Collapse
Affiliation(s)
- Vikas Bhatia
- Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ajay Kumar
- Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rajeev Chauhan
- Department of Anaesthesia, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Navneet Singla
- Department of Neurosurgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
3
|
Bhatia V, Kumar A, Wani MY, Singla N, Prabhakar A, Karthigeyan M, Chauhan R. Therapeutic Neurointervention through Transradial Approach: Preliminary Experience from a Tertiary Care Center. INDIAN JOURNAL OF NEUROSURGERY 2022. [DOI: 10.1055/s-0042-1758778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Abstract
Aim The aim of this study was to assess the safety and feasibility of radial access for therapeutic neurointervention procedures.
Methods The retrospective evaluation of 20 patients taken for therapeutic neurointervention through transradial access at our institute was done from July 2021 to April 2022.
Results Therapeutic neurointervention procedures were attempted in 20 patients (age, 24–74 years; mean age, 48.4 years; 13 (65%) females using a transradial approach. The radial artery's mean diameter was 2.135 mm. The right radial access was taken in 18 (90%) cases. Indications for treatment were ruptured aneurysm in 13 (65%), mechanical thrombectomy in 5 (25%), flow diversion for a recanalized aneurysm in 1 (5%), and balloon occlusion test in 1 (5%) case. The procedure was successful through the transradial approach in 18 (90%) procedures. Failure was seen in two cases that were completed after conversion to the transfemoral approach. The reason for access conversion was a severe spasm in both cases. No significant access site complications were seen in the study cohort.
Conclusion A radial access route is a promising approach for therapeutic interventions with a high success rate and minimal access site complications. Interventionists should get accustomed to this approach as primary or alternative access for neurointervention.
Collapse
Affiliation(s)
- Vikas Bhatia
- Department of Radio-Diagnosis, Section of Neuroimaging and Interventional Neuroradiology, PGIMER Chandigarh, India
| | - Ajay Kumar
- Department of Radio-Diagnosis, Section of Neuroimaging and Interventional Neuroradiology, PGIMER Chandigarh, India
| | - Mohd Yaqoob Wani
- Department of Radio-Diagnosis, Section of Neuroimaging and Interventional Neuroradiology, PGIMER Chandigarh, India
| | | | - Anuj Prabhakar
- Department of Radio-Diagnosis, Section of Neuroimaging and Interventional Neuroradiology, PGIMER Chandigarh, India
| | | | | |
Collapse
|
4
|
Alkhars H, Haq W, Al-Tayeb A, Sigounas D. Feasibility and Safety of Transradial Aneurysm Embolization: A Systematic Review and Meta-Analysis. World Neurosurg 2022; 165:e110-e127. [PMID: 35654332 DOI: 10.1016/j.wneu.2022.05.112] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Use of the transradial access (TRA) approach for neuroendovascular procedures has been increasing in recent years. Our aim is to assess the feasibility, success rate, and complications associated with TRA for intracranial aneurysm embolization. METHODS PubMed, Scopus, and Embase were systematically searched for studies using TRA for intracranial aneurysm embolization. Random-effects models were used to obtain pooled rates of procedural success and complications. RESULTS Twenty-four studies comprising 1283 (85.9%) TRA and 122 (8.2%) distal TRA aneurysm embolization procedures were included. The pooled success rate of the 18 studies in the meta-analysis was 93.5% (95% confidence interval [CI], 91.1%-95.8%). The pooled thromboembolic complication rate was 0.5% (95% CI, 0.1%-0.9%), the hemorrhagic complication rate was 0.5% (95% CI, 0.1%-0.9%), and the access site complication rate was 0.8% (95% CI, 0.3%-1.3%). One study (4.3%) used exclusively a 7-French guide catheter, and most used a 6-French guide catheter (22 of 23 studies, 95.7%), which was further incorporated as part of a triaxial configuration through a sheathless 8-French system in 4 studies (17.4%), 7-French guide catheter in 2 studies (8.7%), and 8-French sheath in 1 study (4.3%). The embolization techniques used were flow diverter placement in 451 cases (39.1%), coiling in 376 (32.6%), stent-assisted coiling in 127 (11.0%), balloon-assisted coiling in 104 (9.0%), Woven EndoBridge system in 50 (4.3%), and flow diverter placement plus coiling in 42 (3.6%). CONCLUSIONS Treating intracranial aneurysms using various embolization techniques through TRA is feasible and associated with low access site and intraoperative complications.
Collapse
Affiliation(s)
- Hussain Alkhars
- George Washington University School of Medicine & Health Sciences, Washington, DC, USA
| | - Waqas Haq
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Ahmed Al-Tayeb
- George Washington University School of Medicine & Health Sciences, Washington, DC, USA
| | - Dimitri Sigounas
- Department of Neurosurgery, George Washington University School of Medicine & Health Sciences, Washington, DC, USA.
| |
Collapse
|
5
|
Saal-Zapata G, Rodríguez-Varela R. Initial Experience Using the Transradial Approach for Endovascular Treatment of Vascular Pathologies: Safety and Feasibility. J Neurosci Rural Pract 2022; 13:123-128. [PMID: 35110932 PMCID: PMC8803504 DOI: 10.1055/s-0041-1742136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background
Endovascular treatment of vascular pathologies through the transradial approach has been increasingly used and has demonstrated a low rate of complications.
Objective
To report our initial experience in the endovascular treatment of cerebrovascular diseases with the transradial approach and to determine its safety and feasibility.
Methods
Consecutive patients who underwent the transradial approach for endovascular treatment of aneurysms and vascular malformations were reviewed at a single institution. Technical success, fluoroscopy time, and access-related complications were analyzed.
Results
Eight patients underwent endovascular treatment with the transradial approach. One arteriovenous fistula, one superficial temporal artery aneurysm, three arteriovenous malformations, and four aneurysms were treated successfully. The radial artery was successfully approached and a 6-F sheath was used in all the cases. Navigation of guiding catheters (5 and 6 F) was done without complications. The most commonly approached artery was the right internal carotid artery, followed by the right vertebral artery. Postoperative vasospasm was identified in three patients. Mean fluoroscopy time was 34.7 minutes. Conversion to transfemoral approach was not required. No postoperative complications were reported.
Conclusions
In our initial experience, the transradial approach is a safe and feasible alternative for the endovascular treatment of cerebrovascular pathologies.
Collapse
Affiliation(s)
- Giancarlo Saal-Zapata
- Department of Neurosurgery, Hospital Nacional Guillermo Almenara Irigoyen, La Victoria, Lima, Peru
| | - Rodolfo Rodríguez-Varela
- Department of Neurosurgery, Hospital Nacional Guillermo Almenara Irigoyen, La Victoria, Lima, Peru
| |
Collapse
|
6
|
Hanaoka Y, Koyama JI, Yamazaki D, Fujii Y, Ogiwara T, Horiuchi T. Transradial quadraxial system for coil embolization of distal anterior cerebral artery aneurysms: A radial-first center case series and literature review. J Neuroradiol 2021; 49:169-172. [PMID: 34634296 DOI: 10.1016/j.neurad.2021.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 09/10/2021] [Accepted: 09/10/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE Endovascular treatment is technically challenging as distal anterior cerebral artery (DACA) aneurysms have distal location, small-caliber parent artery, and small size/wide neck. This study evaluated the feasibility and safety of the transradial approach (TRA) with a radial-specific neurointerventional guiding sheath as the first-line technique for DACA aneurysms. METHODS We retrospectively analyzed an institutional database of consecutive patients with DACA aneurysm who underwent coil embolization using TRA. Ten consecutive patients were included in this study. After the radial-specific 6F Simmons guiding sheath (0.088″ inner diameter) was completely engaged into the target common carotid artery, a quadraxial system (6F Simmons guiding sheath/6F intermediate catheter/3.2F intermediate catheter/single microcatheter) was used for embolization. Then, we assessed for procedural success, angiographic outcomes, and procedure-related or vascular access site complications. RESULTS Embolization procedures were conducted using simple coiling in eight and stent-assisted coiling with the trans-cell approach in two patients. The embolization procedure was successful in all patients (n = 10). Moreover, none presented with catheter kinking, parent artery flow stagnation, or system instability during the procedure. Immediate postprocedural angiography revealed complete obliteration in six and residual neck in four patients. Then, eight patients underwent follow-up angiography at a mean of 7.1 months, and none developed recanalization or required retreatment. The postprocedural course was uneventful, and there were no complications. CONCLUSION The transradial quadraxial system had the ability to achieve sufficient stability and kink resistance in DACA aneurysm embolization. Thus, this method was feasible and safe and had a high success rate.
Collapse
Affiliation(s)
- Yoshiki Hanaoka
- Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan.
| | - Jun-Ichi Koyama
- Neuroendovascular Therapy Center, Shinshu University Hospital, Matsumoto, Japan
| | - Daisuke Yamazaki
- Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yu Fujii
- Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Toshihiro Ogiwara
- Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Tetsuyoshi Horiuchi
- Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan
| |
Collapse
|
7
|
Goland J, Doroszuk GF. Transradial Approach to Cerebral Aneurysm Occlusion in a Patient with an Aberrant Right Subclavian Artery: A Case Report. AMERICAN JOURNAL OF CASE REPORTS 2021; 22:e931443. [PMID: 34172695 PMCID: PMC8244373 DOI: 10.12659/ajcr.931443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Retroesophageal right subclavian artery, aberrant right subclavian artery, or lusoria artery constitutes an anatomical variation with a very low prevalence in the general population. Its presence in a patient does not add difficulty for cerebral arteries catheterization when a femoral approach is used, but may make the catheterization of cerebral vessels difficult when a right transradial approach is used. Unfortunately, this type of configuration of the artery is discovered after the decision to use the type of approach. CASE REPORT A 60-year-old woman with a diagnosed subarachnoid hemorrhage was studied with angiography through a transradial approach. A left carotid bifurcation aneurysm was diagnosed after three-vessel angiography was performed with a Simmons type 2 catheter, making a complete loop between the right subclavian artery, aortic arc, and left carotid artery. The ruptured cerebral aneurysm was completely occluded with 8 coils. The microcatheter used for the procedure emerged from the tip of an intermediate catheter located at the union of the vertical and horizontal segment of the petrous segment of the left carotid artery. CONCLUSIONS The presence of an aberrant right subclavian artery during cerebral angiography performed through a right transradial approach renders the treatment of a left carotid cerebral aneurysms more difficult but not impossible. Utilizing an appropriate intermediate catheter allows for stable navigation of the microcatheter and complete treatment of the aneurysm. This is the first report of cerebral aneurysm embolization through a right transradial approach in a patient with an aberrant right subclavian artery.
Collapse
Affiliation(s)
- Javier Goland
- Department of Neurosurgery, Hospital de Clinicas 'José de San Martín', University of Buenos Aires, Buenos Aires, MN, Argentina
| | - Gustavo F Doroszuk
- Deparment of Neurosurgery, Hospital de Clinicas 'José de San Martín', University of Buenos Aires, Buenos Aires, Argentina
| |
Collapse
|
8
|
Hassan AE, Burke EM, Monayao M, Tekle WG. Utilization of the Ballast Long Guiding Sheath for Neuroendovascular Procedures: Institutional Experience in 68 Cases. Front Neurol 2021; 12:578446. [PMID: 34025546 PMCID: PMC8137819 DOI: 10.3389/fneur.2021.578446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 04/12/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The rise of neurointerventional devices has created a demand for guide systems capable of navigating to the carotid artery consistently regardless of tortuosity. The shift toward large distal access catheters (DACs) and desire for greater trackability have inspired the creation of flexible, supportive, large-lumen long guiding sheaths. Recently, the Ballast long guiding sheath was introduced to provide stability and flexibility while navigating neurointerventional devices through tortuous intracranial anatomy. Objective: To report our experience using the Ballast long guiding sheath in a series of patients undergoing a variety of neuroendovascular procedures. Methods: We retrospectively identified all patients who underwent neuroendovascular treatment with a long guiding sheath were selected from a prospectively maintained endovascular database from January 2019 to November 2019. Baseline clinical characteristics and procedural details were collected. Results: A total of 68 patients were included, mean patient age 67.6 ± 13.6 years. Of the patients treated, 52.9% (36/68) presented with stenosis, 25% (17/68) with aneurysms, 13.2% (9/68) with stroke or emboli, 1.5% (1/68) with a tumor, 1.5% (1/68) with an arteriovenous fistula (AVF), and 4.4% (3/68) with a carotid web. Of the patients with stenosis, 20/36 (55.6%) were extracranial, and 16/36 (44.4%) were intracranial. The Ballast long guiding sheath was used to deliver treatment devices for stenting (37/68, 54.4%), flow diversion (12/68, 17.6%), mechanical thrombectomy (8/68, 11.8%), endovascular coiling (5/68, 7.4%), liquid embolization (3/68, 4.4%), balloon angioplasty (2/68, 2.9%), and balloon angioplasty with stenting (1/68, 1.5%). No Ballast-related complications or adverse events were encountered. Conclusions: We demonstrate the feasibility of the Ballast long guiding sheath to successfully deliver modern neurointerventional treatment devices through tortuous anatomy.
Collapse
Affiliation(s)
- Ameer E Hassan
- Department of Neurology, University of Texas Rio Grande Valley, Harlingen, TX, United States.,Department of Neuroscience, Valley Baptist Neuroscience Institute, Harlingen, TX, United States
| | - Elizabeth M Burke
- Department of Biological Sciences, The Ohio State University, Columbus, OH, United States
| | - Marlon Monayao
- Department of Neuroscience, Valley Baptist Neuroscience Institute, Harlingen, TX, United States
| | - Wondwossen G Tekle
- Department of Neurology, University of Texas Rio Grande Valley, Harlingen, TX, United States.,Department of Neuroscience, Valley Baptist Neuroscience Institute, Harlingen, TX, United States
| |
Collapse
|
9
|
Goland J, Doroszuk G, Ypa P, Leyes P, Garbugino S. Outpatient treatment of cerebral aneurysms: A case series. Surg Neurol Int 2020; 11:400. [PMID: 33274113 PMCID: PMC7708966 DOI: 10.25259/sni_569_2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 10/24/2020] [Indexed: 01/10/2023] Open
Abstract
Background: Major advances in the endovascular treatment of cerebral aneurysms have reduced the incidence of intra- and postprocedural complications. The length of stay after treatment for incidental aneurysms remains between early next-day discharge and 2 days. We hypothesized that discharging patients the same day would not be associated with any increase in the rate of postdischarge adverse events. Methods: We retrospectively reviewed the charts of patients who underwent an elective coiling procedure between 2015 and 2020 at three centers and were discharged from hospital on the same day as the procedure. Patients were clinically evaluated 6 h, 1 week, and 6 months after the procedure, with repeat cerebral angiography performed 1 year after the procedure. Results: Eleven eligible patients underwent outpatient treatment of 12 aneurysms treated through the wrist. No complications were identified within 1 week of the procedure. Clinical evaluation 6 months after treatment also failed to reveal any complication associated with the procedure. Only one of the seven patients who underwent 1 year angiography required retreatment. Conclusion: It is possible to safely perform coiled embolization of cerebral aneurysms in select outpatients with unruptured cerebral aneurysms.
Collapse
Affiliation(s)
- Javier Goland
- Department of Neurosurgery, University of Buenos Aires, Buenos Aires.,Neurointervention Section, Hospital El Cruce, Florencio Varela.,Neurointervention Section, Sanatorio Anchorena, San Martín
| | - Gustavo Doroszuk
- Neurointervention Section, Hospital El Cruce, Florencio Varela.,Neurointervention Section, Sanatorio Anchorena, San Martín
| | - Paula Ypa
- Department of Neurosurgery, University of Buenos Aires, Buenos Aires.,Neurointervention Section, Sanatorio Anchorena, San Martín
| | - Paula Leyes
- Neurointervention Section, Hospital El Cruce, Florencio Varela
| | - Silvia Garbugino
- Department of Neurosurgery, University of Buenos Aires, Buenos Aires
| |
Collapse
|
10
|
Zalocar LAD, Doroszuk G, Goland J. Transradial approach and its variations for neurointerventional procedures: Literature review. Surg Neurol Int 2020; 11:248. [PMID: 32905334 PMCID: PMC7468190 DOI: 10.25259/sni_366_2020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 07/23/2020] [Indexed: 12/20/2022] Open
Abstract
Background: The transfemoral approach (TFA) has been the standard in neuroradiology over the years. However, the transradial approach (TRA) and its variants offer several benefits over the TFA. Methods: Review of the literature about TRA and its variations. We present our results for different neurointerventional procedures at our institution between January 2018 and December 2019. Results: We wrote an educational review describing anatomical and technical aspects, advantages, and complications of this approach. In the past year we increased the percentage of neurointerventional procedures performed through radial or ulnar arteries. Conclusion: There are clearly proven benefits of employing a wrist approach in patients for neurointerventional procedures and its utilization should especially be considered on a daily basis.
Collapse
Affiliation(s)
| | - Gustavo Doroszuk
- Neurointervention Section, Hospital El Cruce Néstor Kirchner, Florencio Varela
| | - Javier Goland
- Neurointervention Section, Hospital El Cruce Néstor Kirchner, Florencio Varela.,Department of Neurosurgery, University of Buenos Aires, Buenos Aires, Argentina
| |
Collapse
|
11
|
Goland J, Domitrovic L, Doroszuk G, Garbugino S, Ypa P. Distal radial approach for neurointerventional diagnosis and therapy. Surg Neurol Int 2019; 10:211. [PMID: 31768291 PMCID: PMC6826296 DOI: 10.25259/sni_410_2019] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 10/09/2019] [Indexed: 12/05/2022] Open
Abstract
Background: The transradial approach results in fewer complications at the puncture site, lower hospital costs, and greater comfort for patients. The distal transradial approach (dTRA) adds some benefits over the conventional radial approach. The objective is to describe initial experience with distal radial approach technique and the results obtained for neuroendovascular diagnostic and therapeutic procedures. Methods: Description of distal radial approach technique and obtained data from the first 3 months experience using this approach as the first choice for neuroendovascular procedures in two neuroendovascular centers. Results: Of the total of 94 procedures performed during 3 months, 67 were diagnostic and 27 were therapeutic. Eleven (16%) of the diagnostic procedures were performed through the dTRA. Of the 27 embolizations, eight (30%) were done using this approach. Every distal radial approach that was performed for diagnosis and therapeutics was successful. Conclusion: Puncture of the radial artery within the anatomical snuffbox is a radial approach variation option for diagnostic and therapeutic neuroendovascular procedures.
Collapse
Affiliation(s)
- Javier Goland
- Neurointervencionismo, Hospital El Cruce, Florencio Varela, Buenos Aires.,Neurocirugía, Hospital de Clinicas, UBA, Buenos Aires, Argentina
| | - Luis Domitrovic
- Radiología, Hospital Vithas Parque San Antonio, Málaga, España
| | - Gustavo Doroszuk
- Neurointervencionismo, Hospital El Cruce, Florencio Varela, Buenos Aires
| | - Silvia Garbugino
- Neurocirugía, Hospital de Clinicas, UBA, Buenos Aires, Argentina
| | - Paula Ypa
- Neurocirugía, Hospital de Clinicas, UBA, Buenos Aires, Argentina
| |
Collapse
|