Lessons Learned After 760 Neurointerventions via the Upper Extremity Vasculature: Pearls and Pitfalls

Area of Science:

• Interventional Neurology
• Vascular Access Techniques
• Neuroendovascular Surgery

Background:

• The radial artery approach is increasingly adopted in neurointervention, drawing from positive cardiology literature on safety and reduced morbidity.
• Growing evidence supports the radial approach for its favorable safety profile in vascular interventions.

Purpose of the Study:

• To evaluate the institutional experience with the radial approach for neuroendovascular procedures.
• To assess the safety, efficacy, and outcomes of radial artery access in a large cohort of patients.

Main Methods:

• Retrospective analysis of 760 neuroendovascular procedures in 614 patients.
• Data collection on access sites (conventional radial, distal radial, ulnar, brachial), procedure types, and complication rates.

Main Results:

• The radial approach was used in 760 procedures, with 34.2% therapeutic and 65.7% diagnostic angiograms.
• Major access site complications were low (0.9%), with a transfemoral conversion rate of 4.7%.
• Procedural efficiency improved after 14 cases, indicating a learning curve for operators.

Conclusions:

• Radial artery catheterization is a safe and effective option for diverse neuroendovascular procedures.
• The approach is associated with excellent clinical outcomes and a low incidence of periprocedural complications.