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Radial access for cerebrovascular procedures: Case report and technical note.
- Source :
-
Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences [Interv Neuroradiol] 2016 Apr; Vol. 22 (2), pp. 227-35. Date of Electronic Publication: 2015 Dec 11. - Publication Year :
- 2016
-
Abstract
- Background: Advantages of radial access over brachial/axillary or femoral access have been well described for several decades and include decreased cost, patient preference, and decreased major access site complications. Despite these advantages, radial access is rarely employed or even considered for neurointerventional procedures. This attitude should be reconsidered given several recent large, randomized, controlled trials from the cardiovascular literature proving that radial access is associated with statistically lower costs, decreased incidence of myocardial infarctions, strokes, and even decreased mortality. Radial access is now considered the standard of care for percutaneous coronary interventions in most US centers. Although radial access has been described for neurovascular procedures in the past, overall experience is limited. The two major challenges are the unique anatomy required to access the cerebral vasculature given very acute angles between the arm and craniocervical vessels and limitations in available technology.<br />Methods: We present a simplified approach to radial access for cerebrovascular procedures and provide a concise step-by-step approach for patient selection, ultrasound-guided single-wall access, recommended catheters/wires, and review of patent hemostasis. Additionally, we present a complex cerebrovascular intervention in which standard femoral access was unsuccessful, while radial access was quickly achieved to highlight the importance of familiarity with the radial approach for all neurointerventionalists.<br />Results: We have found that the learning curve is not too steep and that the radial access approach can be adopted smoothly for a large percentage of diagnostic and interventional neuroradiologic procedures.<br />Conclusions: Radial access should be considered in all patients undergoing a cerebrovascular procedure.<br /> (© The Author(s) 2015.)
- Subjects :
- Abducens Nerve Diseases surgery
Aged, 80 and over
Cerebellar Neoplasms surgery
Cerebellopontine Angle surgery
Cerebral Angiography
Cerebrovascular Disorders diagnostic imaging
Female
Fluoroscopy
Humans
Magnetic Resonance Angiography
Postoperative Complications diagnostic imaging
Postoperative Complications epidemiology
Surgery, Computer-Assisted
Treatment Outcome
Ultrasonography, Interventional
Cerebrovascular Disorders surgery
Neurosurgical Procedures methods
Radial Artery diagnostic imaging
Vascular Surgical Procedures methods
Subjects
Details
- Language :
- English
- ISSN :
- 1591-0199
- Volume :
- 22
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences
- Publication Type :
- Academic Journal
- Accession number :
- 26659807
- Full Text :
- https://doi.org/10.1177/1591019915617314