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The Rationale Behind Transcirculation Neuroendovascular Interventions: Literature Review Through a Case-Series

Marco Colasurdo1, Gautam Edhayan1, Alaha Al Taweel1

  • 1Department of Radiology, Division of Neuroradiology, The University of Texas Medical Branch, Galveston, Texas, USA.

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This summary is machine-generated.

Transcirculation approaches offer a valuable alternative for complex neurovascular interventions when standard methods fail. These retrograde techniques provide crucial access for challenging cases, enhancing treatment options for neurointerventionalists.

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Area of Science:

  • Neurosurgery
  • Endovascular Therapy
  • Cerebrovascular Interventions

Background:

  • Advanced endovascular techniques enable complex neurointerventional procedures.
  • Transcirculation approaches provide alternative access when anterograde routes are difficult or impossible.

Purpose of the Study:

  • To retrospectively review cerebrovascular interventions performed via transcirculation approach.
  • To analyze the utility and outcomes of transcirculation techniques in neurointerventional procedures.

Main Methods:

  • Retrospective collection of English-language studies on transcirculation interventions until August 2022.
  • Analysis of intervention types, case numbers, rationales, and complications.
  • Inclusion of institutional cases performed by current staff.

Main Results:

  • A total of 273 transcirculation treatment approaches were reported, including our cases.
  • Common indications include aneurysm embolization, stroke thrombectomies, and arteriovenous malformation/fistula embolization.
  • Primary reasons for retrograde approach: aneurysm coiling (116), difficult angulation (91), parent vessel occlusion (55).

Conclusions:

  • Transcirculation approaches are viable when conventional anterograde treatments are not feasible.
  • They serve as a crucial bailout strategy for failed or complicated interventions.
  • Experienced neurointerventionalists can safely utilize these techniques for challenging cases.