Tom Boeken1, Adnan Altayeb1, Eimad Shotar1, Kévin Premat1, Stéphanie Lenck1, Anne-Laure Boch2, Mehdi Drir3, Nader-Antoine Sourour1, Frédéric Clarençon4,5,6. 1. Department of Neuroradiology, Sorbonne University. APHP. Pitié-Salpêtrière Hospital, 47, Bd de l'Hôpital, 75013, Paris, France. 2. Department of Neurosurgery, Sorbonne University. APHP. Pitié-Salpêtrière Hospital, Paris, France. 3. Department of Anesthesiology, Sorbonne University. APHP. Pitié-Salpêtrière Hospital, Paris, France. 4. Department of Neuroradiology, Sorbonne University. APHP. Pitié-Salpêtrière Hospital, 47, Bd de l'Hôpital, 75013, Paris, France. frederic.clarencon@aphp.fr. 5. Sorbonne University, Paris, France. frederic.clarencon@aphp.fr. 6. GRC BioFast. Sorbonne University, Paris, France. frederic.clarencon@aphp.fr.
Abstract
OBJECTIVE: To evaluate the feasibility, safety, and rate of radial artery occlusion (RAO) after the treatment of intracranial aneurysms using a 6F Neuron MAX (Penumbra, Alameda, CA, USA) long sheath directly into the radial artery. METHODS: All consecutive patients treated for unruptured intracranial aneurysms with TRA using a 6F Neuron MAX catheter between September 2019 and May 2021 in a single tertiary center were screened. They were referred to a consultation and an ultrasound-Doppler assessment of the radial artery 3 months after treatment with the attending neuroradiologist. Patients with available assessment of the radial artery patency were included. RESULTS: A total of 17 patients (median age: 58 years, range 35-68 years; sex ratio F/M: 15/2) were treated for intracranial aneurysms using a 6F Neuron MAX directly into the right radial artery and included. Treatment was a technical success for 16/17 (94%) patients and 1 patient (6%) required a conversion to femoral access. The median radial artery diameter at the puncture site was 2.7 mm (range 1.8-2.9mm). No symptomatic RAO was noted during follow-up. Assessment at 3 months revealed 7/17 (41%) asymptomatic RAOs. CONCLUSION: Even if technically feasible, the use of a 6F Neuron Max long sheath for triaxial catheterization in intracranial interventions, especially flow diversion, may be responsible for a high radial artery occlusion rate (41%). Although being asymptomatic in all cases in our series, this high occlusion rate may be a concern for further interventions. The development of dedicated radial long sheaths for neurointerventions, with external hydrophilic coating, seems necessary.
OBJECTIVE: To evaluate the feasibility, safety, and rate of radial artery occlusion (RAO) after the treatment of intracranial aneurysms using a 6F Neuron MAX (Penumbra, Alameda, CA, USA) long sheath directly into the radial artery. METHODS: All consecutive patients treated for unruptured intracranial aneurysms with TRA using a 6F Neuron MAX catheter between September 2019 and May 2021 in a single tertiary center were screened. They were referred to a consultation and an ultrasound-Doppler assessment of the radial artery 3 months after treatment with the attending neuroradiologist. Patients with available assessment of the radial artery patency were included. RESULTS: A total of 17 patients (median age: 58 years, range 35-68 years; sex ratio F/M: 15/2) were treated for intracranial aneurysms using a 6F Neuron MAX directly into the right radial artery and included. Treatment was a technical success for 16/17 (94%) patients and 1 patient (6%) required a conversion to femoral access. The median radial artery diameter at the puncture site was 2.7 mm (range 1.8-2.9mm). No symptomatic RAO was noted during follow-up. Assessment at 3 months revealed 7/17 (41%) asymptomatic RAOs. CONCLUSION: Even if technically feasible, the use of a 6F Neuron Max long sheath for triaxial catheterization in intracranial interventions, especially flow diversion, may be responsible for a high radial artery occlusion rate (41%). Although being asymptomatic in all cases in our series, this high occlusion rate may be a concern for further interventions. The development of dedicated radial long sheaths for neurointerventions, with external hydrophilic coating, seems necessary.
Authors: Andre Monteiro; Alexander G Fritz; Justin M Cappuzzo; Muhammad Waqas; Elad I Levy; Adnan H Siddiqui Journal: Interv Neuroradiol Date: 2022-04-26 Impact factor: 1.610