Transradial approach for flow diversion treatment of cerebral aneurysms: A multicenter study

Stephanie H. Chen, Brian M. Snelling, Sumedh Subodh Shah, Samir Sur, Marie Christine Brunet, Robert M. Starke, Dileep R Yavagal, Joshua W. Osbun, Eric C. Peterson

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: The transradial approach (TRA) to endovascular procedures decreases access site morbidity and mortality in comparison with the traditional transfemoral technique (TFA). Despite its improved safety profile, there is a concern that TRA is less favorable for neurointerventional procedures that require large coaxial systems to manage the small tortuous cerebral vessels. Objective: To report our experience with TRA for flow diverter placement for treatment of unruptured cerebral aneurysms. Methods: We performed a retrospective review of prospective institutional databases at two high-volume centers to identify 49 patients who underwent flow diversion for aneurysm treatment via primary TRA between November 2016 and November 2018. Patient demographics, procedural techniques, and clinical data were recorded. Results: Of the 49 patients, 39 underwent successful flow diversion placement by TRA. Ten patients were converted to TFA after attempted TRA. There were no procedural complications. Reasons for failure included tortuosity in eight patients and severe radial artery spasm in two. Conclusions: In the largest reported series to date of flow diverter deployment via TRA for aneurysm treatment, we demonstrate the technical feasibility and safety of the method. The most common reason for failure of TRA was an acute angle of left common carotid artery origin or left internal carotid artery tortuosity. Overall, our data suggest that increasing adoption of TRA is merited given its apparent equivalence to the current TFA technique and its documented reduction in access site complications.

Original languageEnglish (US)
JournalJournal of NeuroInterventional Surgery
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Intracranial Aneurysm
Multicenter Studies
Aneurysm
Therapeutics
Safety
Endovascular Procedures
Radial Artery
Common Carotid Artery
Spasm
Internal Carotid Artery
Demography
Databases
Morbidity
Mortality

Keywords

  • aneurysm
  • flow diverter
  • intervention
  • technique

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Chen, S. H., Snelling, B. M., Shah, S. S., Sur, S., Brunet, M. C., Starke, R. M., ... Peterson, E. C. (Accepted/In press). Transradial approach for flow diversion treatment of cerebral aneurysms: A multicenter study. Journal of NeuroInterventional Surgery. https://doi.org/10.1136/neurintsurg-2018-014620

Transradial approach for flow diversion treatment of cerebral aneurysms : A multicenter study. / Chen, Stephanie H.; Snelling, Brian M.; Shah, Sumedh Subodh; Sur, Samir; Brunet, Marie Christine; Starke, Robert M.; Yavagal, Dileep R; Osbun, Joshua W.; Peterson, Eric C.

In: Journal of NeuroInterventional Surgery, 01.01.2019.

Research output: Contribution to journalArticle

Chen, Stephanie H. ; Snelling, Brian M. ; Shah, Sumedh Subodh ; Sur, Samir ; Brunet, Marie Christine ; Starke, Robert M. ; Yavagal, Dileep R ; Osbun, Joshua W. ; Peterson, Eric C. / Transradial approach for flow diversion treatment of cerebral aneurysms : A multicenter study. In: Journal of NeuroInterventional Surgery. 2019.
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