[The "Essence" and "Devices" in Transradial Neurointervention]

Transradial neurointervention (TRN) benefits patients and neurointerventionalists. The radial artery is small in diameter and prone to vasospasm; thus, it must be handled gently from puncture to hemostasis. Ultrasound-guided puncture is recommended. Normal variations, such as the brachioradial artery or radial artery loop, should be considered. The size of the catheter system was selected based on radial artery diameter. The sheath-to-artery ratio must be ≤1, particularly with large-bore catheter systems or sheathless technique. The difficulty of TRN and system stability vary depending on the transradial approach side, aortic arch type, target vessel, including the common carotid and vertebral arteries, and proximal target vessel trajectory. The optimal system setup should be determined before TRN. Hemostasis should be performed using a hemostatic device, applying minimal compression and completing hemostasis within 120 min to minimize the risk of radial artery occlusion.