Department of Neurological Surgery, University of Miami, Jackson Health System, Lois Pope Life Center, 2nd Floor, 1095 Northwest 14th Terrace, Miami, FL 33136, USA.
Department of Neurological Surgery, University of Miami, Jackson Health System, Lois Pope Life Center, 2nd Floor, 1095 Northwest 14th Terrace, Miami, FL 33136, USA.
Neurosurg Clin N Am. 2022 Apr;33(2):149-159. doi: 10.1016/j.nec.2021.11.003. Epub 2022 Mar 2.
Transradial access (TRA) has gained traction in neurointerventions as studies continue to demonstrate improved access site safety and equivalent end artery effectiveness when compared with traditional transfemoral techniques. Herein, we describe the technical nuances of obtaining TRA with a focus on distal TRA, left TRA, and sheathless TRA using larger bore catheters. We also discuss various strategies to avoid access site conversion if radial artery spasm or radial anomalies are encountered and offer some solutions for forming the Simmons catheter especially when it cannot be performed in the descending aorta. Lastly, we provide some insights regarding contraindications to TRA.
经桡动脉入路（TRA）在神经介入中得到了广泛应用，研究继续表明与传统的经股动脉技术相比，TRA 可提高入路部位的安全性和等效的终动脉效果。在此，我们描述了使用较大口径导管获得 TRA 的技术要点，重点介绍了远端 TRA、左侧 TRA 和无鞘 TRA。我们还讨论了如果遇到桡动脉痉挛或桡动脉异常时避免入路转换的各种策略，并提供了一些解决方案，特别是当 Simmons 导管无法在降主动脉中形成时。最后，我们就 TRA 的禁忌证提供了一些见解。
