Rajah Gary B, Lieber Bryan, Kappel Ari D, Luqman Ali W
Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.
Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, NY, USA.
Brain Circ. 2020 Feb 18;6(1):60-64. doi: 10.4103/bc.bc_22_19. eCollection 2020 Jan-Mar.
Recent trends in neuroendovascular surgery have seen a rise in alternative access utilization. Social media feeds such as #RadialFirst or #RadialForNeuro are the beacons of a growing movement among more and more endovascular neurosurgeons, as they venture away from the traditional femoral access gravitating toward radial access. We have previously shown our distal radial access technique utilizing the snuffbox to be a reliable means of endovascular access and in addition to traditional ventral radial access provides access to the entire cerebrum. Stroke thrombectomy often encounters reticence from those who prefer transfemoral access over the radial access. Thrombectomy has been performed radially in a few series and only once previously in a case report of distal radial access for thrombectomy. Hesitance to adopt radial access for mechanical thrombectomy is often related to perceived increased access times and a lack of suitable balloon guide catheters for radial techniques. Here, we present one of the first descriptions of a distal transradial access with balloon guide flow arrest for stentriever thrombectomy.
神经血管内手术的最新趋势显示，替代入路的使用有所增加。诸如#RadialFirst或#RadialForNeuro等社交媒体动态是越来越多血管内神经外科医生中日益壮大的运动的标志，因为他们正逐渐远离传统的股动脉入路，转而倾向于桡动脉入路。我们之前已经展示了利用鼻烟壶的桡动脉远端入路技术是一种可靠的血管内入路方式，除了传统的桡动脉腹侧入路外，还能实现对整个大脑的入路。在中风取栓手术中，那些更喜欢经股动脉入路而非桡动脉入路的人往往对此持保留态度。已经有一些系列报道采用桡动脉入路进行取栓手术，之前仅有一例关于桡动脉远端入路取栓的病例报告。对于采用桡动脉入路进行机械取栓的犹豫通常与预计的增加的入路时间以及缺乏适用于桡动脉技术的球囊导引导管有关。在此，我们首次描述了一种用于支架取栓的带球囊导引导管血流阻断的桡动脉远端入路。
