Abstract
The transradial approach (TRA) has become more and more popular in the neuroendovascular field. The advantages of TRA that have led to increased use in the brain aneurysm embolization are discussed. The relevant anatomy, TRA failure, and crossover into the transfemoral approach are reviewed. Setup the TRA approach, preprocedure preparation, TRA puncture techniques, and the radial sheaths are introduced. The techniques for catheterizing different supra-aortic arch arteries are described in detail. The left TRA-related issues and indications are also reviewed. The specific aspects of the application of TRA for aneurysm embolization are reviewed. Challenges and complications related to TRA are other important topics of this chapter.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Gao F, Lo WJ, Sun X, et al. Selective use of transradial access for endovascular treatment of severe intracranial vertebrobasilar artery stenosis. Clin Neurol Neurosurg. 2015;134:116–21.
Layton KF, Kallmes DF, Cloft HJ. The radial artery access site for interventional neuroradiology procedures. AJNR Am J Neuroradiol. 2006;27(5):1151–4.
Kok MM, Weernink MGM, von Birgelen C, Fens A, van der Heijden LC, van Til JA. Patient preference for radial versus femoral vascular access for elective coronary procedures: the PREVAS study. Catheter Cardiovasc Interv. 2018;91(1):17–24.
Stone JG, Zussman BM, Tonetti DA, et al. Transradial versus transfemoral approaches for diagnostic cerebral angiography: a prospective, single-center, non-inferiority comparative effectiveness study. J Neurointerv Surg. 2020;12(10):993–8.
Sakai H, Ikeda S, Harada T, et al. Limitations of successive transradial approach in the same arm: the Japanese experience. Catheter Cardiovasc Interv. 2001;54(2):204–8.
Haussen DC, Nogueira RG, DeSousa KG, et al. Transradial access in acute ischemic stroke intervention. J Neurointerv Surg. 2016;8(3):247–50.
Sattur MG, Almallouhi E, Lena JR, Spiotta AM. Illustrated guide to the Transradial approach for Neuroendovascular surgery: a step-by-step description gleaned from over 500 cases at an early adopter single center. Oper Neurosurg (Hagerstown). 2020;19(2):181–9.
Joshi KC, Beer-Furlan A, Crowley RW, Chen M, Munich SA. Transradial approach for neurointerventions: a systematic review of the literature. J Neurointerv Surg. 2020;12(9):886–92.
Snelling BM, Sur S, Shah SS, Marlow MM, Cohen MG, Peterson EC. Transradial access: lessons learned from cardiology. J Neurointerv Surg. 2018;10(5):487–92.
Lo TS, Nolan J, Fountzopoulos E, et al. Radial artery anomaly and its influence on transradial coronary procedural outcome. Heart. 2009;95(5):410–5.
Brunet MC, Chen SH, Sur S, et al. Distal transradial access in the anatomical snuffbox for diagnostic cerebral angiography. J Neurointerv Surg. 2019;11(7):710–3.
Barbeau GR, Arsenault F, Dugas L, Simard S, Lariviere MM. Evaluation of the ulnopalmar arterial arches with pulse oximetry and plethysmography: comparison with the Allen's test in 1010 patients. Am Heart J. 2004;147(3):489–93.
Snelling BM, Sur S, Shah SS, et al. Transradial cerebral angiography: techniques and outcomes. J Neurointerv Surg. 2018;10(9):874–81.
Mendiz OA, Fava C, Lev G, Caponi G, Valdivieso L. Transradial versus Transfemoral carotid artery stenting: a 16-year single-center experience. J Interv Cardiol. 2016;29(6):588–93.
Koutouzis MJ, Maniotis CD, Avdikos G, Tsoumeleas A, Andreou C, Kyriakides ZS. ULnar artery transient compression facilitating radial artery patent hemostasis (ULTRA): a novel technique to reduce radial artery occlusion after Transradial coronary catheterization. J Invasive Cardiol. 2016;28(11):451–4.
Barros G, Bass DI, Osbun JW, et al. Left transradial access for cerebral angiography. J Neurointerv Surg. 2020;12(4):427–30.
Kado H, Patel AM, Suryadevara S, et al. Operator radiation exposure and physical discomfort during a right versus left radial approach for coronary interventions: a randomized evaluation. JACC Cardiovasc Interv. 2014;7(7):810–6.
Chivot C, Bouzerar R, Yzet T. Transitioning to Transradial access for cerebral aneurysm embolization. AJNR Am J Neuroradiol. 2019;40(11):1947–53.
Hanaoka Y, Koyama JI, Ogiwara T, Fujii Y, Ito K, Horiuchi T. Feasibility and safety of radial-first approach with a radial-specific Neurointerventional guiding sheath for intracranial aneurysm coiling in the anterior circulation. World Neurosurg. 2020;142:e297–306.
Chen SH, Snelling BM, Shah SS, et al. Transradial approach for flow diversion treatment of cerebral aneurysms: a multicenter study. J Neurointerv Surg. 2019;11(8):796–800.
Brunet MC, Chen SH, Peterson EC. Transradial access for neurointerventions: management of access challenges and complications. J Neurointerv Surg. 2020;12(1):82–6.
Seto AH, Roberts JS, Abu-Fadel MS, et al. Real-time ultrasound guidance facilitates transradial access: RAUST (radial artery access with ultrasound trial). JACC Cardiovasc Interv. 2015;8(2):283–91.
Bernat I, Abdelaal E, Plourde G, et al. Early and late outcomes after primary percutaneous coronary intervention by radial or femoral approach in patients presenting in acute ST-elevation myocardial infarction and cardiogenic shock. Am Heart J. 2013;165(3):338–43.
Deftereos S, Giannopoulos G, Raisakis K, et al. Moderate procedural sedation and opioid analgesia during transradial coronary interventions to prevent spasm: a prospective randomized study. JACC Cardiovasc Interv. 2013;6(3):267–73.
Kwok CS, Rashid M, Fraser D, Nolan J, Mamas M. Intra-arterial vasodilators to prevent radial artery spasm: a systematic review and pooled analysis of clinical studies. Cardiovasc Revasc Med. 2015;16(8):484–90.
Chugh SK, Chugh Y, Chugh S. How to tackle complications in radial procedures: tip and tricks. Indian Heart J. 2015;67(3):275–81.
Guedes A, Dangoisse V, Gabriel L, et al. Low rate of conversion to transfemoral approach when attempting both radial arteries for coronary angiography and percutaneous coronary intervention: a study of 1,826 consecutive procedures. J Invasive Cardiol. 2010;22(9):391–7.
Saito S, Ikei H, Hosokawa G, Tanaka S. Influence of the ratio between radial artery inner diameter and sheath outer diameter on radial artery flow after transradial coronary intervention. Catheter Cardiovasc Interv. 1999;46(2):173–8.
Aykan AC, Gokdeniz T, Gul I, et al. Comparison of low dose versus standard dose heparin for radial approach in elective coronary angiography? Int J Cardiol. 2015;187:389–92.
Pancholy S, Coppola J, Patel T, Roke-Thomas M. Prevention of radial artery occlusion-patent hemostasis evaluation trial (PROPHET study): a randomized comparison of traditional versus patency documented hemostasis after transradial catheterization. Catheter Cardiovasc Interv. 2008;72(3):335–40.
Author information
Authors and Affiliations
Rights and permissions
Copyright information
© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
Ren, Z. (2022). Transradial Access. In: Eight Aneurysms. Springer, Cham. https://doi.org/10.1007/978-3-030-97216-5_5
Download citation
DOI: https://doi.org/10.1007/978-3-030-97216-5_5
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-97215-8
Online ISBN: 978-3-030-97216-5
eBook Packages: MedicineMedicine (R0)