Neurosurg Focus. 2019 Jan 1;46(Suppl_1):V5. doi: 10.3171/2019.1.FocusVid.18420.
In elderly patients with acute ischemic stroke, tortuosity of the proximal vertebral artery makes access from the transfemoral route challenging and time consuming. In such cases, a transradial approach (TA) offers a more direct vertebral artery (VA) access that overcomes proximal VA tortuosity. In this video the authors illustrate nuances of the TA for acute basilar artery occlusion in two patients with challenging proximal VA anatomy. Techniques, devices, and pitfalls are discussed. In both patients, mechanical clot retrieval was successful and resulted in significant recovery of function. The authors believe that the TA should be the initial approach for basilar artery (BA) occlusion management in elderly patients and should be considered for selected patients with other conditions requiring endovascular treatment.The video can be found here: https://youtu.be/_Ym9tMKUy_4.
在急性缺血性脑卒中的老年患者中，椎动脉近端迂曲使得经股动脉入路变得具有挑战性且耗时。在这种情况下，经桡动脉入路（TA）提供了一种更直接的椎动脉（VA）入路，可以克服近端 VA 迂曲。在这段视频中，作者展示了两名近端 VA 解剖结构具有挑战性的患者中急性基底动脉闭塞的 TA 细微差别。讨论了技术、设备和陷阱。在这两名患者中，机械取栓均获得成功，并导致功能显著恢复。作者认为，TA 应该是老年患者基底动脉（BA）闭塞管理的初始入路，并且应该考虑用于需要血管内治疗的其他情况下的选定患者。该视频可在此处找到：https://youtu.be/_Ym9tMKUy_4。
