Overtake Technique for Navigating 8Fr Emboguard Balloon Guide Catheter for Anterior Circulation Neurointervention

Area of Science:

• Neurointerventional radiology
• Vascular access techniques
• Cerebrovascular procedures

Background:

• The transradial approach (TRA) is an emerging neurointerventional option using balloon guide catheters (BGCs).
• Large-bore BGCs may be limited by small radial artery (RA) size and navigation challenges to the left anterior circulation.
• The overtake technique offers a potential solution for navigating BGCs via TRA.

Purpose of the Study:

• To determine the feasibility and safety of the overtake technique for navigating 8Fr EmboGuard BGCs using the TRA.
• To assess the success rate and complications associated with this technique in patients with adequate RA diameter.

Main Methods:

• Retrospective review of patients undergoing TRA with 8Fr EmboGuard BGCs.
• BGCs navigated using the overtake technique with long Simmons arm inner catheters in the common carotid arteries.
• Minimum RA diameter of ≥2.8 mm was required; outcomes evaluated at 90 days.

Main Results:

• 28 procedures were performed in 26 patients, with 96.4% success using the 8Fr EmboGuard TRA without conversion.
• One case required BGC exchange due to herniation into the aortic arch.
• Radial artery occlusion occurred in 3.8% of patients without ischemic complications.

Conclusions:

• The overtake technique is feasible and safe for navigating 8Fr EmboGuard BGCs via TRA in patients with RAs ≥2.8 mm.
• The technique's success is independent of sheathless or sheath-based insertion methods.
• This approach expands the utility of TRA for neurointerventional procedures requiring large-bore BGCs.