A novel 3-Fr guiding sheath for transradial access in aneurysm embolization: Technical note

Area of Science:

• Interventional Neuroradiology
• Vascular Surgery
• Medical Device Technology

Background:

• Transradial access (TRA) for neurointervention is limited by narrow radial arteries.
• Existing guiding sheaths may not be suitable for patients with radial artery diameters less than 2 mm.

Purpose of the Study:

• To evaluate the feasibility and safety of a novel 3-Fr guiding sheath (GS) for aneurysm embolization via TRA in patients with small radial arteries.
• To describe the technical aspects and potential pitfalls of this technique.

Main Methods:

• Two patients with radial arteries <2 mm underwent aneurysm embolization using a 3-Fr GS (outer diameter 1.76 mm).
• Procedures included coil embolization for an intracranial aneurysm and stent-assisted embolization for an extracranial aneurysm.
• A 0.0165-inch microcatheter was used for embolization.

Main Results:

• Complete occlusion of both aneurysms was achieved.
• No neurological complications or puncture site issues (hematoma, radial artery occlusion, vasospasm) occurred.
• This represents the first reported use of a 3-Fr GS for neurointervention via TRA.

Conclusions:

• The novel 3-Fr GS facilitates successful transradial aneurysm embolization in patients with narrow radial arteries.
• This approach is safe and effective, offering a viable solution for challenging neurointerventional cases.
• The 3-Fr GS expands treatment options for aneurysm embolization via TRA in patients with small radial arteries.