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Updated: Sep 11, 2025
Simulator Training for Endovascular Neurosurgery
Published on: May 6, 2020
Use of an intermediate catheter with internal guide wire support for transradial embolisation of intracranial
1Stroke Center, Henan Provincial People's Hospital, Zhengzhou University, 7 Weiwu Road, Zhengzhou, Henan Province, 450003, China.
Insights
This study shows that using an intermediate catheter with guide wire support via transradial access is a safe and effective method for the endovascular embolisation of intracranial aneurysms.
Area of Science:
- Neurosurgery
- Interventional Radiology
- Vascular Neurology
Background:
- Intracranial aneurysms pose a significant risk of subarachnoid hemorrhage.
- Endovascular embolisation is a primary treatment modality for these aneurysms.
- Transradial access offers potential advantages over transfemoral approaches.
Purpose of the Study:
- To evaluate the safety and efficacy of a specific technique for intracranial aneurysm embolisation.
- The technique involves using an intermediate catheter with internal guide wire support.
- The access route investigated is transradial access.
Main Methods:
- Retrospective analysis of 50 patients with 57 intracranial aneurysms.
- Endovascular treatment performed via transradial access (right or left).
- Techniques included coil embolisation alone and stent-assisted coiling, utilizing various microcatheters and guide wires (0.018-inch and 0.035-inch).
Main Results:
- Successful embolisation (Raymond grade I or II) was achieved in 98.2% of aneurysms immediately post-procedure.
- Follow-up angiography showed excellent occlusion rates (91.4% Raymond grade I).
- A low complication rate was observed, including one case of non-symptomatic radial artery occlusion.
Conclusions:
- The intermediate catheter technique with internal guide wire support via transradial access is safe and effective.
- This approach provides a viable alternative for endovascular embolisation of intracranial aneurysms.
- The findings support the routine use of this technique in clinical practice.
Aim:
The aim of this study was to investigate the safety and effect of the technique using an intermediate catheter with internal guide wire support for embolisation of intracranial aneurysms through the transradial access.
Materials And Methods:
Fifty patients aged 53.2 ± 8.9 (range: 35-82) years with 57 intracranial aneurysms were retrospectively enrolled. The clinical data, treatment, and follow-up outcomes were analysed.
Results:
Aneurysm rupture was found in 14 (28%) patients, with aneurysm size ranging 2 to 12 (6.8 ± 1.6) mm. Endovascular treatment was performed through the transradial access on the right in 42 (84%) patients and on the left in 8 (16%). Coil embolisation alone was conducted in 17 (34%) patients, including use of a single microcatheter in 14 (28%) patients and double microcatheters in 3 (6%). Stent-assisted coiling was performed for wide-necked aneurysms in 40 (80%) patients, including use of a microcatheter in 36 (72%) patients and double microcatheters in 4 (8%). A 0.018-inch guide wire was used in 46 (92%) patients, and a 0.035-inch guide wire was used in the rest 4 (8%). Immediately after embolisation, Raymond grade I embolisation was achieved in 48 (84.2%) aneurysms, grade II in 8 (14.0%), and grade III in 1 (1.8%). One (2%) patient had nonsymptomatic occlusion of the punctured radial artery. Thirty-two (64%) patients with 35 (61.4%) aneurysms had angiographic follow-up, including Raymond grade I occlusion in 32 (91.4%) aneurysms and grade II in 3 (8.6%).
Conclusion:
Use of the intermediate catheter technique with internal guide wire support through the transradial access is safe and effective in endovascular embolisation of intracranial aneurysms.
