Transradial access for neurointerventional procedures: A practical approach

Mohammad Hossein Mirbolouk; Feizollah Ebrahimnia; Reza Gorji; Payam Sasannejad; Samira Zabihyan; Mohammad Adeeb Hoveizavi; Yousefali Garivani; Zahra Mirzaasgari; Saeed Abdollahifard; Ashkan Mowla; Humain Baharvahdat

doi:10.4103/bc.bc_101_22

Transradial access for neurointerventional procedures: A practical approach

Brain Circ. 2023 Jun 30;9(2):88-93. doi: 10.4103/bc.bc_101_22. eCollection 2023 Apr-Jun.

Authors

Affiliations

¹ Department of Neurosurgery, Section of Neurovascular Intervention, Neurosurgical, Mashhad University of Medical Sciences, Mashhad, Iran.
² Department of Neurosurgery, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.
³ Department of Neurology, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.
⁴ Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.
⁵ Research Center for Neuromodulation and Pain, Shiraz, Iran.
⁶ Department of Neurological Surgery, Division of Stroke and Endovascular, Keck School of Medicine, Neurosurgery, University of Southern California, Los Angeles, CA, USA.
⁷ Department of Interventional Neuroradiology, Rothschild Foundation Hospital, Paris, France.

Abstract

Introduction: Transradial approach (TRA) is a new technique proposed for performing cerebral angiography and neuro-interventional procedures. In this article, we sought to provide a step-by-step guide for carrying out a diagnostic cerebral angiography using this approach and summarize our center's experience.

Material and methods: Records of patients since January 2020 were investigated, and data on demographic indices, reports of the procedures, outcomes, and complications were extracted. Then, these data were used to develop a step-by-step instruction for TRA cerebral angiography.

Results: Two hundred eighty-nine patients matched our eligibility criteria with a mean age of 50 years and a female-to-male ratio of 1.18. Overall, TRA was carried out successfully for 97.2% (281 patients). In case TRA failed, transfemoral approach was considered for the procedure. Three minor complications (two vasospasm and one small hematoma) and two major complications (one pseudoaneurysm of the radial artery and one radial artery avulsion) were observed.

Conclusion: This article covers challenges a neurointerventionalist may face during a diagnostic cerebral angiography using TRA. Furthermore, our findings indicated that cerebral angiography with TRA might be performed safely and with a great success rate.

Keywords: Cerebral angiography; neuro-interventional; transradial approach (TRA).