Yamazaki Daisuke, Yokota Akifumi, Satoh Daisuke, Yako Takehiro, Kitazawa Kazuo, Horiuchi Tetsuyoshi, Kobayashi Shigeaki
Department of Neurosurgery, Aizawa Hospital, Matsumoto, Nagano, Japan; Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.
Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.
J Clin Neurosci. 2025 Sep 4;141:111609. doi: 10.1016/j.jocn.2025.111609.
The transradial approach (TRA) is gaining popularity in neuroendovascular therapy due to its safety and patient comfort, but its application in emergency settings with complex vascular anatomy remains technically demanding. This study assessed the feasibility and safety of using the 6 Fr FUBUKI XF long guiding sheath-a non-radial-specific device-for neuroendovascular procedures via TRA. Nineteen consecutive patients treated with the FUBUKI XF long guiding sheath between April 2024 and June 2025 were retrospectively reviewed and compared with a small cohort treated using the radial-specific Rist guiding sheath during the same period. The FUBUKI XF cohort had a mean age of 70.2 years, and 57.9 % were female. Most procedures (73.7 %) were for ruptured aneurysms. Anatomical challenges included type III aortic arch and aberrant right subclavian artery. Technical access success was achieved in 94.7 % of cases, with one case converted to transfemoral access. Median procedure time was 111.0 min (IQR, 72.0), median fluoroscopy time was 54.0 min (IQR, 35.3), and median DAP was 153.0 Gy·m (IQR, 46.0). Intermediate catheters were employed in 94.7 % of procedures. One case of carotid dissection required stenting, but no major access-site complications occurred. The FUBUKI XF sheath's atraumatic tip, flexible shaft, and high trackability enabled effective navigation and support. These findings suggest that the FUBUKI XF is a feasible and safe option for TRA-based neurointerventions, with performance comparable to radial-specific devices in complex anatomical scenarios.
经桡动脉途径（TRA）因其安全性和患者舒适度，在神经血管内治疗中越来越受欢迎，但在血管解剖结构复杂的急诊情况下应用，技术上仍具有挑战性。本研究评估了使用6 Fr FUBUKI XF长引导鞘（一种非桡动脉专用装置）经TRA进行神经血管内手术的可行性和安全性。回顾性分析了2024年4月至2025年6月期间连续19例使用FUBUKI XF长引导鞘治疗的患者，并与同期一小群使用桡动脉专用的Rist引导鞘治疗的患者进行比较。FUBUKI XF组患者的平均年龄为70.2岁，女性占57.9%。大多数手术（73.7%）是针对破裂动脉瘤。解剖学挑战包括III型主动脉弓和右锁骨下动脉异常。94.7%的病例实现了技术入路成功，1例转为经股动脉入路。中位手术时间为111.0分钟（四分位间距，72.0），中位透视时间为54.0分钟（四分位间距，35.3），中位剂量面积乘积（DAP）为153.0 Gy·m（四分位间距，46.0）。94.7%的手术使用了中间导管。1例颈动脉夹层需要置入支架，但未发生主要入路部位并发症。FUBUKI XF鞘的无创伤尖端、柔性轴和高跟踪性使其能够有效导航和支撑。这些发现表明，FUBUKI XF对于基于TRA的神经介入治疗是一种可行且安全的选择，在复杂解剖情况下的性能与桡动脉专用装置相当。
