Atchley Travis, Schmalz Philip
Neurological Surgery, University of Alabama at Birmingham, Birmingham, USA.
Cureus. 2024 Jan 31;16(1):e53337. doi: 10.7759/cureus.53337. eCollection 2024 Jan.
Transradial access has garnered increasing popularity and acceptance among the neuro-interventional community. As this technique becomes commonplace for both diagnostic and interventional procedures, an understanding of potential complications and management is tantamount. Here, we describe two cases of thrombosed radial arteries successfully recanalized with traditional thrombectomy techniques. Two patients presented with aneurysmal subarachnoid hemorrhage and were found to have ruptured anterior communicating artery aneurysms. Both patients were deemed appropriate candidates for endovascular treatment. During attempted access, both patients were found to have occluded right radial arteries due to previous arterial access, one from a prior intervention and one from an arterial line placed at another facility. Thrombectomies were subsequently performed, one via manual aspiration through the access sheath and the other with a commercially available aspiration system. Both radial arteries were successfully recanalized and the interventions were completed via transradial access. Endovascular thrombectomy for radial artery thrombosis is a feasible and simple technique that can be employed to facilitate transradial access for neuro-endovascular procedures when a thrombosed radial artery is encountered. This technique can be attempted in cases of radial artery thrombosis prior to conversion to transfemoral access.
经桡动脉入路在神经介入领域越来越受到欢迎和认可。随着这项技术在诊断和介入手术中变得越来越普遍，了解其潜在并发症及处理方法至关重要。在此，我们描述两例采用传统血栓切除术成功再通的桡动脉血栓形成病例。两名患者均表现为动脉瘤性蛛网膜下腔出血，经检查发现前交通动脉动脉瘤破裂。两名患者均被认为适合进行血管内治疗。在尝试入路时，由于既往的动脉穿刺，两名患者的右侧桡动脉均闭塞，其中一例是由于先前的介入操作，另一例是由于在其他机构放置的动脉导管。随后进行了血栓切除术，一例通过经穿刺鞘手动抽吸，另一例使用市售的抽吸系统。两条桡动脉均成功再通，并且通过经桡动脉入路完成了介入治疗。当遇到桡动脉血栓形成时，血管内血栓切除术治疗桡动脉血栓是一种可行且简单的技术，可用于促进神经血管内手术的经桡动脉入路。在转为经股动脉入路之前，对于桡动脉血栓形成的病例可尝试使用该技术。
