Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA 19107, United States.
J Clin Neurosci. 2019 Nov;69:261-264. doi: 10.1016/j.jocn.2019.08.018. Epub 2019 Aug 31.
The distal transradial access in the anatomical snuffbox for neurovascular procedures is a modification of the radial access with an improved safety profile and patient comfort compared to the conventional transradial access. However, its use has been limited to diagnostic cerebral angiography, but not aneurysm treatment. We present the first case of a 53-year-old female whose work-up for headaches showed an anterior communicating artery aneurysm. The patient underwent distal transradial cerebral angiography and subsequent placement of a Woven EndoBridge (WEB) device for treatment of the aneurysm through the same access site. The procedure was uneventful and the patient was discharged home neurologically intact. Her hand remained warm, well-perfused, and with no visible or palpable hematoma. Our report illustrates the feasibility of the distal TRA for the treatment of cerebral aneurysms using the WEB device. Further studies are necessary to confirm the additional benefits of the distal TRA over TRA for neurovascular access.
经解剖鼻烟窝的远端桡动脉入路用于神经血管操作，是桡动脉入路的一种改良，与传统的桡动脉入路相比，具有更好的安全性和患者舒适度。然而，其应用仅限于诊断性脑血管造影，而不是动脉瘤治疗。我们报告首例 53 岁女性病例，该患者因头痛就诊，检查发现前交通动脉瘤。患者接受远端桡动脉脑血管造影，随后通过相同入路部位放置编织型 EndoBridge（WEB）装置治疗动脉瘤。手术过程顺利，患者出院时神经功能完整。她的手保持温暖、灌注良好，没有可见或可触及的血肿。我们的报告说明了使用 WEB 装置通过远端 TRA 治疗脑动脉瘤的可行性。需要进一步的研究来证实远端 TRA 在神经血管入路上相对于 TRA 的额外益处。
