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Transradial Access

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Eight Aneurysms
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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.

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References

  1. 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.

    Article  PubMed  Google Scholar 

  2. Layton KF, Kallmes DF, Cloft HJ. The radial artery access site for interventional neuroradiology procedures. AJNR Am J Neuroradiol. 2006;27(5):1151–4.

    CAS  PubMed  PubMed Central  Google Scholar 

  3. 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.

    Article  PubMed  Google Scholar 

  4. 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.

    Article  PubMed  Google Scholar 

  5. 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.

    Article  CAS  PubMed  Google Scholar 

  6. Haussen DC, Nogueira RG, DeSousa KG, et al. Transradial access in acute ischemic stroke intervention. J Neurointerv Surg. 2016;8(3):247–50.

    Article  PubMed  Google Scholar 

  7. 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.

    Article  Google Scholar 

  8. 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.

    Article  PubMed  PubMed Central  Google Scholar 

  9. 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.

    Article  PubMed  Google Scholar 

  10. 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.

    Article  CAS  PubMed  Google Scholar 

  11. 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.

    Article  PubMed  Google Scholar 

  12. 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.

    Article  PubMed  Google Scholar 

  13. Snelling BM, Sur S, Shah SS, et al. Transradial cerebral angiography: techniques and outcomes. J Neurointerv Surg. 2018;10(9):874–81.

    Article  PubMed  Google Scholar 

  14. 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.

    Article  PubMed  Google Scholar 

  15. 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.

    PubMed  Google Scholar 

  16. Barros G, Bass DI, Osbun JW, et al. Left transradial access for cerebral angiography. J Neurointerv Surg. 2020;12(4):427–30.

    Article  PubMed  Google Scholar 

  17. 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.

    Article  PubMed  Google Scholar 

  18. Chivot C, Bouzerar R, Yzet T. Transitioning to Transradial access for cerebral aneurysm embolization. AJNR Am J Neuroradiol. 2019;40(11):1947–53.

    CAS  PubMed  PubMed Central  Google Scholar 

  19. 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.

    Article  PubMed  Google Scholar 

  20. 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.

    Article  PubMed  Google Scholar 

  21. Brunet MC, Chen SH, Peterson EC. Transradial access for neurointerventions: management of access challenges and complications. J Neurointerv Surg. 2020;12(1):82–6.

    Article  PubMed  Google Scholar 

  22. 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.

    Article  PubMed  Google Scholar 

  23. 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.

    Article  PubMed  Google Scholar 

  24. 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.

    Article  PubMed  Google Scholar 

  25. 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.

    Article  PubMed  Google Scholar 

  26. Chugh SK, Chugh Y, Chugh S. How to tackle complications in radial procedures: tip and tricks. Indian Heart J. 2015;67(3):275–81.

    Article  PubMed  PubMed Central  Google Scholar 

  27. 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.

    PubMed  Google Scholar 

  28. 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.

    Article  CAS  PubMed  Google Scholar 

  29. 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.

    Article  PubMed  Google Scholar 

  30. 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.

    Article  PubMed  Google Scholar 

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Ren, Z. (2022). Transradial Access. In: Eight Aneurysms. Springer, Cham. https://doi.org/10.1007/978-3-030-97216-5_5

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  • DOI: https://doi.org/10.1007/978-3-030-97216-5_5

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-97215-8

  • Online ISBN: 978-3-030-97216-5

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