PTFE-covered stent-grafts significantly improved TIPS patency in swine (P < .01). However, stenosis in the hepatic vein led to late shunt malfunction in selected cases.
Percutaneous angioplasty is a useful method for improvement of posterior circulation of the brain in subclavian artery stenosis and occlusion. Recently, the Palmaz stent was introduced for peripheral vessels stenosis. We evaluated the efficacy and care point of Palmaz stent deployment for subclavian artery stenosis in seven cases (5 stenosis and 2 occlusion) with symptoms and a mean age of 65.1 years. The stents could be deployed exactly at the stenotic region in all cases. The pressure gradient disappeared in all cases, and the clots were fixed between vessel wall and stent. Antegrade circulation and significant clinical symptoms improvement were obtained in all cases. In angioplasty of subclavian artery stenosis, as compared with balloon angioplasty alone, Palmaz stent is a very useful device with fewer complications including distal thrombosis of the vertebrobasilar circulation.
Material and Methods We retrospectively reviewed our prospectively maintained Neuro IR database and identified all patients who underwent transradial access for their diagnostic or interventional procedure between May 2019 and January 2021. Patient demographics, clinical information, procedural and radiographic data were collected. Results We identified 749 patients in whom transradial access was obtained for either diagnostic and interventional Neuro IR procedures. Access was obtained using a 5F/6F/7F radial sheath. In some procedures, the sheath was exchanged for the guide catheter which was then inserted in a bareback (sheathless) fashion. Interventional procedures performed included carotid artery stenting, stroke thrombectomy, intracranial stenting, thrombolysis for central retinal artery occlusion, aneurysm treatment (with coiling or stent-assisted coiling, flow diverters or Woven EndoBridge device placement), vasospasm treatment, arteriovenous malformation and dural arteriovenous fistula embolization, middle meningeal artery embolization, and spinal angiography with embolization. A total of 12 access site complications were recorded (1.6%) with 4 access site hematomas, 3 inflammatory changes at the puncture site, 2 asymptomatic radial artery occlusions, 2 radial artery injuries (1 self-limiting wire perforation and 1 perforation which was coiled via transfemoral route without any clinical sequela) and 1 retained broken microwire which was successfully removed in a subsequent session. None of the complications resulted in permanent local or neurological deficits. Conclusion The transradial approach for diagnostic and interventional Neuro IR procedures is a safe vascular access choice.
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