Joshua H Weinberg1, Ahmad Sweid2, Ameer Hassan3, Wondwossen Tekle4, Kalyan Sajja5, Lauren Thaete6, Michael Reid Gooch7, Hekmat Zarzour8, Stavropoula Tjoumakaris9, Robert H Rosenwasser10, Pascal Jabbour11. 1. Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA USA. Electronic address: Joshua.weinberg@jefferson.edu. 2. Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA USA. Electronic address: ahmad.sweid@jefferson.edu. 3. Department of Neuroscience, Valley Baptist Medical Center, Harlingen, TX USA. Electronic address: ameerehassan@gmail.com. 4. Department of Neuroscience, Valley Baptist Medical Center, Harlingen, TX USA. Electronic address: tekl0027@umn.edu. 5. Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA USA. Electronic address: kalyan.sajja@jefferson.edu. 6. Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA USA. Electronic address: lauren.thaete@jefferson.edu. 7. Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA USA. Electronic address: Reid.gooch@jefferson.edu. 8. Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA USA. Electronic address: Hekmat.zarzour@jefferson.edu. 9. Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA USA. Electronic address: stavropoula.tjoumakaris@jefferson.edu. 10. Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA USA. Electronic address: robert.rosenwasser@jefferson.edu. 11. Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA USA. Electronic address: pascal.jabbour@jefferson.edu.
Abstract
BACKGROUND: Transradial access (TRA) for neuroendovascular procedures has several clear benefits compared to transfemoral access. In this study, we report our initial experience with neuroendovascular procedures performed via transradial access using the novel Ballast 088 long sheath. METHODS: We conducted a retrospective analysis and identified 91 consecutive patients who underwent neuroendovascular procedures via TRA using the Ballast 088 long sheath. Data collection was performed on indication for procedure, number of vessels selectively catheterized, fluoroscopy time, procedure duration, radiation exposure, failure of radial access and conversion to transfemoral access, periprocedural complications, and procedural outcomes. RESULTS: Amongst 91 patients, the average age was 65.5 years ± 14.2 with 45 (49.5 %) female patients. 25 (27.5 %) patients underwent aneurysm treatment, 2 (2.2 %) AVM/AVF embolization, 28 (30.8 %) intracranial or extracranial stenting, 31 (34.1 %) stroke treatment, and 5 (5.5 %) underwent diagnostic angiogram. The mean number of target vessels catheterized was 1.07 ± 0.25, the mean procedure duration (minutes) was 96.5 ± 57.2, mean fluoroscopy time (minutes) was 21.9 ± 14.2, mean contrast dose (ml) was 112.7 ± 66.7, and mean radiation exposure (Gycm2) was 54.82 ± 41.37. The success rate of target vessel catheterization was 100 %. There were no complications resulting in long term sequelae. Access complications occurred in 1 (1.1 %) patients. Transfemoral conversion was required in 3 (3.3 %) patients. CONCLUSIONS: The Ballast 088 long sheath is safe and effective for TRA in neuroendovascular procedures with a low rate of complications and conversion.
BACKGROUND: Transradial access (TRA) for neuroendovascular procedures has several clear benefits compared to transfemoral access. In this study, we report our initial experience with neuroendovascular procedures performed via transradial access using the novel Ballast 088 long sheath. METHODS: We conducted a retrospective analysis and identified 91 consecutive patients who underwent neuroendovascular procedures via TRA using the Ballast 088 long sheath. Data collection was performed on indication for procedure, number of vessels selectively catheterized, fluoroscopy time, procedure duration, radiation exposure, failure of radial access and conversion to transfemoral access, periprocedural complications, and procedural outcomes. RESULTS: Amongst 91 patients, the average age was 65.5 years ± 14.2 with 45 (49.5 %) female patients. 25 (27.5 %) patients underwent aneurysm treatment, 2 (2.2 %) AVM/AVF embolization, 28 (30.8 %) intracranial or extracranial stenting, 31 (34.1 %) stroke treatment, and 5 (5.5 %) underwent diagnostic angiogram. The mean number of target vessels catheterized was 1.07 ± 0.25, the mean procedure duration (minutes) was 96.5 ± 57.2, mean fluoroscopy time (minutes) was 21.9 ± 14.2, mean contrast dose (ml) was 112.7 ± 66.7, and mean radiation exposure (Gycm2) was 54.82 ± 41.37. The success rate of target vessel catheterization was 100 %. There were no complications resulting in long term sequelae. Access complications occurred in 1 (1.1 %) patients. Transfemoral conversion was required in 3 (3.3 %) patients. CONCLUSIONS: The Ballast 088 long sheath is safe and effective for TRA in neuroendovascular procedures with a low rate of complications and conversion.