Hidemichi Ito1, Masashi Uchida2, Hiroshi Takasuna2, Tetsuya Goto2, Ichiro Takumi2, Takayuki Fukano3, Yuta Hagiwara3, Yuichiro Tanaka2. 1. Department of Neurosurgery, St. Marianna University School of Medicine, Kanagawa, Japan. Electronic address: hdmcito@marianna-u.ac.jp. 2. Department of Neurosurgery, St. Marianna University School of Medicine, Kanagawa, Japan. 3. Department of Neurology, St. Marianna University School of Medicine, Kanagawa, Japan.
Abstract
BACKGROUND: The transradial approach using a Simmons-shaped catheter has been increasingly used for diagnostic cerebral angiography and neurointervention. In the transradial approach for neurointervention, the right radial artery is mainly used. However, in interventional cardiology, there are apparent clinical benefits with the left transradial approach for right-handed patients. To our knowledge, no studies have reported on neurointervention with the routine use of the left transradial approach. We therefore devised a novel technique for cases with an unachievable form of the Simmons shape using the standard technique, which we named the "interchange technique". The purpose of this study was to evaluate the technical feasibility of the left transradial neurointervention. METHODS: This study is a retrospective review of our prospective database of consecutive patients who underwent a left transradial neurointervention, using a 6Fr Simmons guiding sheath, performed from January through April 2021. The outcome variables studied were successful catheterization and procedure-related complications. RESULTS: Twenty-one patients underwent a left transradial neurointervention including cerebral aneurysm coiling, carotid artery stenting, and meningioma embolization. The Simmons shape could not be formed with the standard technique for 3 patients, for whom we successfully formed the Simmons shape with our new interchange technique. The procedure was completely achieved in all 21 patients. There were no patients who required crossover to the right radial or femoral arteries, no radial artery spasms or occlusions, or any procedural complications. CONCLUSIONS: The left transradial approach for neurointervention is a technically feasible, safe, and effective alternative while providing more comfort to right-handed patients.
BACKGROUND: The transradial approach using a Simmons-shaped catheter has been increasingly used for diagnostic cerebral angiography and neurointervention. In the transradial approach for neurointervention, the right radial artery is mainly used. However, in interventional cardiology, there are apparent clinical benefits with the left transradial approach for right-handed patients. To our knowledge, no studies have reported on neurointervention with the routine use of the left transradial approach. We therefore devised a novel technique for cases with an unachievable form of the Simmons shape using the standard technique, which we named the "interchange technique". The purpose of this study was to evaluate the technical feasibility of the left transradial neurointervention. METHODS: This study is a retrospective review of our prospective database of consecutive patients who underwent a left transradial neurointervention, using a 6Fr Simmons guiding sheath, performed from January through April 2021. The outcome variables studied were successful catheterization and procedure-related complications. RESULTS: Twenty-one patients underwent a left transradial neurointervention including cerebral aneurysm coiling, carotid artery stenting, and meningioma embolization. The Simmons shape could not be formed with the standard technique for 3 patients, for whom we successfully formed the Simmons shape with our new interchange technique. The procedure was completely achieved in all 21 patients. There were no patients who required crossover to the right radial or femoral arteries, no radial artery spasms or occlusions, or any procedural complications. CONCLUSIONS: The left transradial approach for neurointervention is a technically feasible, safe, and effective alternative while providing more comfort to right-handed patients.