Bilateral Transradial Approach for Coil Embolization of Basilar Artery Aneurysms Associated with an Unfavorable Vertebral Artery Anatomy

Hanaoka, Yoshiki; Koyama, Jun-ichi; Fujii, Yu; Ogiwara, Toshihiro; Itō, Kiyoshi; Horiuchi, Tetsuyoshi

doi:10.1007/s00062-020-00971-6

Cited by 18 publications

(5 citation statements)

References 29 publications

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“…We have employed transradial access as the first-line approach for neurointerventions. [2][3][4][5][6][7][8] We completely agree with the authors' conception that subclavian artery stenting using a combined transradial and transfemoral access with a duallumen compliant balloon catheter (Scepter XC; MicroVention, Aliso Viejo, California) is a useful therapeutic option for patients with symptomatic left proximal subclavian artery stenosis. The preprocedural angiography revealed severe left subclavian artery stenosis with an irregular shape and persisting antegrade flow in the left vertebral artery (VA) in this case.…”

supporting

confidence: 63%

Letter: Combined Transradial and Transfemoral Approach Using a Compliant Balloon for Emboli Protection at the Vertebral Artery During Subclavian Stenosis Stenting: 2-Dimensional Operative Video

2021

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supporting

confidence: 63%

Letter: Combined Transradial and Transfemoral Approach Using a Compliant Balloon for Emboli Protection at the Vertebral Artery During Subclavian Stenosis Stenting: 2-Dimensional Operative Video

2021

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“…To mimic the blood flow dynamics in the basilar artery, a carotid flow pattern was selected. The pGL biomaterial was injected inside the basilar tip aneurysm site using a 4F catheter [Figure b(ii)], which is often used to treat complications in the basilar artery. , Given that the fragmentation of biomaterial during its injection into the aneurysm site under physiological fluid flow is one of the most important concerns, herein, the pGL biomaterial was injected in the model under a carotid fluid flow with a rate of 4 mL s –1 [Figure b(ii)]. The flow rate was ∼2-fold higher than the blood flow rate in the basilar artery …”

Section: Resultsmentioning

confidence: 99%

A Cohesive Shear-Thinning Biomaterial for Catheter-Based Minimally Invasive Therapeutics

Baidya

Haghniaz

Tom

et al. 2022

ACS Appl. Mater. Interfaces

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Shear-thinning hydrogels are suitable biomaterials for catheter-based minimally invasive therapies; however, the tradeoff between injectability and mechanical integrity has limited their applications, particularly at high external shear stress such as that during endovascular procedures. Extensive molecular crosslinking often results in stiff, hard-to-inject hydrogels that may block catheters, whereas weak crosslinking renders hydrogels mechanically weak and susceptible to shear-induced fragmentation. Thus, controlling molecular interactions is necessary to improve the cohesion of catheter-deployable hydrogels. To address this material design challenge, we have developed an easily injectable, nonhemolytic, and noncytotoxic shear-thinning hydrogel with significantly enhanced cohesion via controlling noncovalent interactions. We show that enhancing the electrostatic interactions between weakly bound biopolymers (gelatin) and nanoparticles (silicate nanoplatelets) using a highly charged polycation at an optimum concentration increases cohesion without compromising injectability, whereas introducing excessive charge to the system leads to phase separation and loss of function. The cohesive biomaterial is successfully injected with a neuroendovascular catheter and retained without fragmentation in patient-derived three-dimensionally printed cerebral aneurysm models under a physiologically relevant pulsatile fluid flow, which would otherwise be impossible using the noncohesive hydrogel counterpart. This work sheds light on how charge-driven molecular and colloidal interactions in shear-thinning physical hydrogels improve cohesion, enabling complex minimally invasive procedures under flow, which may open new opportunities for developing the next generation of injectable biomaterials.

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“…Hanaoka et al reported the feasibility and safety of the bilateral transradial approach for coil embolization of basilar artery aneurysms associated with an unfavorable vertebral artery anatomy, including the rolesharing technique. 21) The authors emphasized that the use of two 3.2F intermediate catheters for bilateral vertebral arteries via the bilateral TRA is safe and provides good visualization during the procedures. Luther et al also reported bilateral TRAs in complex posterior circulation interventions.…”

Section: Fig 4 Pre-(a) and Post-embolization (B) Of The Aneurysmmentioning

confidence: 99%

Bilateral Distal Transradial Approach for Coiling of Basilar Artery Aneurysm: A Technical Note

Kinkori

Watanabe

Ishikawa

et al. 2022

Neurol. Med. Chir.(Tokyo)

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Distal transradial approach (dTRA) for neuroendovascular procedures has received much attention in recent years as a newer and less invasive alternative to the conventional transfemoral or transradial approaches. We present the case of an 89-year-old woman with a basilar artery aneurysm requiring simultaneous catheterization of the bilateral vertebral arteries who was successfully embolized using bilateral dTRA. The aneurysm was accessed from the right vertebral artery using the right dTRA. Control angiograms during the procedure were performed from the left vertebral artery via the left dTRA. The operator's posture was ergonomically comfortable, and the catheters were easy to handle during the procedure. To the best of our knowledge, this is the first case of a bilateral dTRA used for neuroendovascular procedures. Bilateral dTRA is a safe and minimally invasive method for patients and ergonomically comfortable for operators.

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Bilateral Transradial Approach for Coil Embolization of Basilar Artery Aneurysms Associated with an Unfavorable Vertebral Artery Anatomy

Cited by 18 publications

References 29 publications

Letter: Combined Transradial and Transfemoral Approach Using a Compliant Balloon for Emboli Protection at the Vertebral Artery During Subclavian Stenosis Stenting: 2-Dimensional Operative Video

Letter: Combined Transradial and Transfemoral Approach Using a Compliant Balloon for Emboli Protection at the Vertebral Artery During Subclavian Stenosis Stenting: 2-Dimensional Operative Video

A Cohesive Shear-Thinning Biomaterial for Catheter-Based Minimally Invasive Therapeutics

Bilateral Distal Transradial Approach for Coiling of Basilar Artery Aneurysm: A Technical Note

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