Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA USA.
Department of Neuroscience, Valley Baptist Medical Center, Harlingen, TX USA.
Clin Neurol Neurosurg. 2021 Mar;202:106510. doi: 10.1016/j.clineuro.2021.106510. Epub 2021 Jan 20.
Transradial access (TRA) for neuroendovascular procedures has several clear benefits compared to transfemoral access. In this study, we report our initial experience with neuroendovascular procedures performed via transradial access using the novel Ballast 088 long sheath.
We conducted a retrospective analysis and identified 91 consecutive patients who underwent neuroendovascular procedures via TRA using the Ballast 088 long sheath. Data collection was performed on indication for procedure, number of vessels selectively catheterized, fluoroscopy time, procedure duration, radiation exposure, failure of radial access and conversion to transfemoral access, periprocedural complications, and procedural outcomes.
Amongst 91 patients, the average age was 65.5 years ± 14.2 with 45 (49.5 %) female patients. 25 (27.5 %) patients underwent aneurysm treatment, 2 (2.2 %) AVM/AVF embolization, 28 (30.8 %) intracranial or extracranial stenting, 31 (34.1 %) stroke treatment, and 5 (5.5 %) underwent diagnostic angiogram. The mean number of target vessels catheterized was 1.07 ± 0.25, the mean procedure duration (minutes) was 96.5 ± 57.2, mean fluoroscopy time (minutes) was 21.9 ± 14.2, mean contrast dose (ml) was 112.7 ± 66.7, and mean radiation exposure (Gycm2) was 54.82 ± 41.37. The success rate of target vessel catheterization was 100 %. There were no complications resulting in long term sequelae. Access complications occurred in 1 (1.1 %) patients. Transfemoral conversion was required in 3 (3.3 %) patients.
The Ballast 088 long sheath is safe and effective for TRA in neuroendovascular procedures with a low rate of complications and conversion.
与经股动脉入路相比,经桡动脉入路(TRA)进行神经血管介入治疗有几个明显的优势。在这项研究中,我们报告了使用新型 Ballast 088 长鞘进行经桡动脉入路神经血管介入治疗的初步经验。
我们进行了回顾性分析,确定了 91 例连续接受经桡动脉入路使用 Ballast 088 长鞘进行神经血管介入治疗的患者。数据采集包括手术适应证、选择性导管化血管数、透视时间、手术时间、辐射暴露、桡动脉入路失败和转为经股动脉入路、围手术期并发症和手术结果。
91 例患者中,平均年龄为 65.5 岁±14.2 岁,其中 45 例(49.5%)为女性患者。25 例(27.5%)患者接受了动脉瘤治疗,2 例(2.2%)动静脉畸形/瘘栓塞,28 例(30.8%)颅内或颅外支架置入,31 例(34.1%)卒中治疗,5 例(5.5%)进行了诊断性血管造影。平均目标血管导管化数量为 1.07±0.25,平均手术时间(分钟)为 96.5±57.2,平均透视时间(分钟)为 21.9±14.2,平均对比剂剂量(毫升)为 112.7±66.7,平均辐射暴露(Gycm2)为 54.82±41.37。目标血管导管化成功率为 100%。无导致长期后遗症的并发症。1 例(1.1%)患者出现入路并发症。3 例(3.3%)患者需要转为经股动脉入路。
Ballast 088 长鞘在神经血管介入治疗中经桡动脉入路是安全有效的,并发症和转换率低。