Abdelsalam Ahmed, Sanikommu Sai, Guada Luis, Ramsay Ian A, Shrigiri Soumya, Silva Michael A, Lu Victor M, Christopher Kara M, Sweid Ahmad, Weinberg Joshua H, Wu Eva M, Rosenwasser Robert H, Tjoumakaris Stavropoula I, Abecassis Isaac Josh, Hassan Ameer E, Jabbour Pascal M, Starke Robert M
Department of Neurological Surgery, Radiology, Neurosciences, Pharmacology, University of Miami School of Medicine, Miami, FL, USA.
Department of Neurological Surgery, Radiology, Neurosciences, Pharmacology, University of Miami School of Medicine, Miami, FL, USA.
J Clin Neurosci. 2025 Sep;139:111460. doi: 10.1016/j.jocn.2025.111460. Epub 2025 Jul 9.
The transradial approach (TRA) for neuroendovascular procedures has gained popularity. There is limited data on the use of large-bore guide catheters in radial approaches. This study evaluates the safety and efficacy of the Ballast 088 long sheath in radial neurointerventional procedures.
We performed a retrospective review of a prospectively maintained neuroendovascular database to assess the Ballast radial access system (Balt USA, LLC) in radial approaches. The primary outcome was technical success, defined as the access catheter reaching its target vessel and completing the procedure without necessitating a shift to femoral access or changing to a different catheter.
There were 138 consecutive patients included in the study. The mean age was 66.7 years (SD ± 15.1); 41.3 % were female. The most common interventions were mechanical thrombectomy for ischemic stroke (31.4 %), carotid stenting for stenosis (24.6 %), and aneurysm embolization (22 %). Challenging anatomic variations included severe vessel tortuosity, type 2 and 3 aortic arch, bovine arch, and a severe angle (<30°) between the subclavian artery and the target vessel. Technical success, defined as reaching the target vessel and successfully completing the procedure without necessitating a shift to femoral access or changing the guide catheter, was achieved in 97.8 % of the cases (135/138). There was one access site complication (temporary spasm; 0.7 %) and no device-related complications.
The use of the Ballast radial access system proved to be safe and feasible. It was successful in treating a wide range of interventional procedures, consistently achieving favorable outcomes via radial access.
经桡动脉途径（TRA）用于神经血管内介入手术已越来越普遍。关于在桡动脉途径中使用大口径导引导管的数据有限。本研究评估了Ballast 088长鞘在桡动脉神经介入手术中的安全性和有效性。
我们对一个前瞻性维护的神经血管内数据库进行了回顾性分析，以评估桡动脉入路的Ballast桡动脉通路系统（美国巴尔的摩公司）。主要结局指标为技术成功，定义为进入导管到达目标血管并完成手术，无需转为股动脉入路或更换为其他导管。
本研究共纳入138例连续患者。平均年龄为66.7岁（标准差±15.1）；41.3%为女性。最常见的干预措施为缺血性卒中的机械取栓术（31.4%）、狭窄的颈动脉支架置入术（24.6%）和动脉瘤栓塞术（22%）。具有挑战性的解剖变异包括严重血管迂曲、2型和3型主动脉弓、牛型弓以及锁骨下动脉与目标血管之间的严重夹角（<30°）。97.8%的病例（135/138）实现了技术成功，即到达目标血管并成功完成手术，无需转为股动脉入路或更换导引导管。有1例穿刺部位并发症（短暂痉挛；0.7%），无器械相关并发症。
Ballast桡动脉通路系统的使用被证明是安全可行的。它成功地用于治疗各种介入手术，通过桡动脉入路始终取得良好的效果。
