McCarthy David J, Chen Stephanie H, Brunet Marie-Christine, Shah Sumedh, Peterson Eric, Starke Robert M
Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.
Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.
World Neurosurg. 2019 Feb;122:355-359. doi: 10.1016/j.wneu.2018.11.030. Epub 2018 Nov 14.
The distal transradial approach (dTRA) is being widely adopted by interventional cardiologists, primarily owing to reduced morbidity and mortality from access site complications. The distal radial artery has advantages over standard radial access in relation to procedural positioning and radial artery preservation, particularly in patients who may require multiple angiograms. One disadvantage is the smaller diameter of the artery with more challenging puncture of a smaller, weaker artery. We demonstrate the feasibility of dTRA in 2 patients who underwent successful diagnostic angiography and mechanical thrombectomy.
Two patients underwent dTRA for neurointerventions. In patient 1, a 5-F Glidesheath Slender and a Sim2 catheter were used for a 6-vessel cerebral angiogram. In patient 2, an 0.88-inch sheathless guide catheter was used to perform a mechanical thrombectomy. Successful hemostasis in both cases was achieved with a Safeguard Radial Compression Device; no complications were observed.
Neurovascular access via dTRA is feasible, and further exploration is warranted.
远端桡动脉入路（dTRA）正被介入心脏病学家广泛采用，主要是因为该入路可降低穿刺部位并发症导致的发病率和死亡率。与标准桡动脉入路相比，远端桡动脉在手术定位和桡动脉保留方面具有优势，尤其是对于可能需要多次血管造影的患者。一个缺点是动脉直径较小，穿刺较小、较细的动脉更具挑战性。我们展示了dTRA在2例成功接受诊断性血管造影和机械取栓术患者中的可行性。
2例患者接受dTRA进行神经介入治疗。患者1使用5F的Glidesheath Slender导管和Sim2导管进行6血管脑动脉造影。患者2使用0.88英寸无鞘导引导管进行机械取栓。两例均使用桡动脉压迫装置成功止血；未观察到并发症。
通过dTRA进行神经血管穿刺是可行的，值得进一步探索。
