Upper extremity transvenous access for neuroendovascular procedures: An international multicenter case series

Isaac Josh Abecassis, Vasu Saini, Timothy John Phillips, Joshua W. Osbun, Mario Martínez-Galdámez, Ahmed Nada, Michael R. Levitt, R. Webster Crowley, Mithun G. Sattur, Alejandro M. Spiotta, Evan Luther, Stephanie H. Chen, Joshua Burks, Pascal Jabbour, Ahmad Sweid, Marios N. Psychogios, Min S. Park, Dileep R. Yavagal, Eric C. Peterson, Muhammad WaqasRimal Hanif Dossani, Jason M. Davies, Alex Brehm, Gregory D. Selkirk, W. Christopher Fox, Daniel Giansante Abud, Jorge Galvan Fernandez, Miguel Schüller Arteaga, Robert M. Starke

Research output: Contribution to journalArticlepeer-review

Abstract

Background Radial artery access for transarterial procedures has gained recent traction in neurointerventional due to decreased patient morbidity, technical feasibility, and improved patient satisfaction. Upper extremity transvenous access (UETV) has recently emerged as an alternative strategy for the neurointerventionalist, but data are limited. Our objective was to quantify the use of UETV access in neurointerventions and to measure failure and complication rates. Methods An international multicenter retrospective review of medical records for patients undergoing UETV neurointerventions or diagnostic procedures was performed. We also present our institutional protocol for obtaining UETV and review the existing literature. Results One hundred and thirteen patients underwent a total of 147 attempted UETV procedures at 13 centers. The most common site of entry was the right basilic vein. There were 21 repeat puncture events into the same vein following the primary diagnostic procedure for secondary interventional procedures without difficulty. There were two minor complications (1.4%) and five failures (ie, conversion to femoral vein access) (3.4%). Conclusions UETV is safe and technically feasible for diagnostic and neurointerventional procedures. Further studies are needed to determine the benefit over alternative venous access sites and the effect on patient satisfaction.

Original languageEnglish (US)
Pages (from-to)357-362
Number of pages6
JournalJournal of neurointerventional surgery
Volume13
Issue number4
DOIs
StatePublished - Apr 1 2021

Keywords

  • angiography
  • intervention
  • technique

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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