Transitioning to Transradial Access for Cerebral Aneurysm Embolization

Area of Science:

• Neurosurgery
• Interventional Neuroradiology
• Vascular Surgery

Background:

• Transradial access (TRA) is increasingly recognized for safety and efficacy in cerebral angiography.
• Neurointerventionalists express apprehension regarding TRA for neurointerventions due to anatomical, technical, and learning curve challenges.
• This study details the transition to TRA for cerebral aneurysm embolization.

Purpose of the Study:

• To demonstrate the feasibility of radial access for cerebral aneurysm embolization.
• To evaluate the safety of TRA in consecutive embolization procedures for ruptured and unruptured cerebral aneurysms.

Main Methods:

• Retrospective review of a prospective database of cerebral aneurysm embolizations (April-December 2018).
• Technical success defined by radial access sheath insertion and procedure completion without femoral crossover.
• Primary safety endpoint: in-hospital and 30-day radial artery occlusion incidence. Secondary endpoints: intraoperative and neurological complications.

Main Results:

• 73 embolizations performed in 71 patients; TRA was the primary access in 87.3% of cases.
• Technical success rate was high, with only 3.1% crossover to femoral access.
• No radial artery occlusion or hand ischemia observed; one intraoperative aneurysm rupture had no clinical impact.

Conclusions:

• Transitioning to transradial access for cerebral aneurysm embolization is feasible.
• TRA does not increase the procedural risk profile for cerebral aneurysm embolization.
• This approach offers a safe and effective alternative for neurointerventional procedures.