Department of Radiology, NYU Langone Medical Center, New York, New York.
Division of Neurosurgery, Maimonides Medical Center, Brooklyn, New York.
Oper Neurosurg (Hagerstown). 2019 Oct 1;17(4):340-347. doi: 10.1093/ons/opy378.
The treatment of selected wide-neck and fusiform posterior circulation aneurysms is challenging for clipping as well as for endovascular route.
To describe an endovascular approach for vertebral artery aneurysm treatment using transradial access (TRA) instead of the conventional transfemoral access.
We collected cases from two institutions in which TRA was used for posterior circulation Pipeline Embolization Device (Medtronic, Dublin, Ireland) deployment.
A total of four patients were treated. TRA was useful in the setting of extreme vessel tortuosity. We utilized 5F Terumo Glidesheath (Terumo Medical, Somerset, New Jersey), intermediate catheter, and a 027 microcatheter for Pipeline deployment. TRA was not associated with any access or deployment difficulties.
Early experience suggests that TRA for Pipeline Embolization Device placement for posterior circulation aneurysm is a safe and efficient alternative to standard transfemoral access. While this approach was initially applied to patients with vascular anatomy that may not allow for safe femoral access or navigation, experience so far argues for considering a radial approach towards some posterior circulation aneurysm treatment.
对于一些宽颈和梭形的后循环动脉瘤，夹闭手术和血管内治疗都具有挑战性。
描述一种使用经桡动脉入路（TRA）的血管内治疗椎动脉动脉瘤的方法，以替代传统的经股动脉入路。
我们收集了两个机构的病例，这些病例均使用 TRA 进行后循环 Pipeline 栓塞装置（美敦力，都柏林，爱尔兰）的部署。
共有 4 名患者接受了治疗。TRA 在极端血管迂曲的情况下非常有用。我们使用了 5F Terumo Glidesheath（泰尔茂医疗，新泽西州萨默塞特）、中间导管和 027 微导管进行 Pipeline 部署。TRA 与任何入路或部署困难无关。
早期经验表明，TRA 用于后循环动脉瘤的 Pipeline 栓塞装置放置是一种安全有效的替代标准经股动脉入路的方法。虽然这种方法最初应用于那些可能不允许安全股动脉入路或导航的血管解剖结构的患者，但迄今为止的经验表明，对于一些后循环动脉瘤的治疗，可以考虑采用桡动脉入路。
