Distal radial artery (Snuffbox) access for intracranial aneurysm treatment using the Woven EndoBridge (WEB) device

Kühn, Anna Luisa; Singh, Jasmeet; Rodrigues, K de Macedo; Massari, Francesco; Moholkar, Viraj M; Marwah, Suroop K.; Unar, Danyal; Gounis, Matthew J.; Puri, Ajit S

doi:10.1016/j.jocn.2020.10.006

Cited by 11 publications

(3 citation statements)

References 25 publications

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“…These findings suggest that TRA has comparable efficacy and safety to TFA and are congruent with those of previously published case reports and small case series. [14][15][16][17][18] Recently, several centers started to use the "radial-first" approach for most neurovascular procedures. [6][7][8]21 Despite comparable outcomes to TFA, there are several limitations to the wider adoption of this approach.…”

Section: Discussionmentioning

confidence: 99%

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Transradial versus transfemoral access for embolization of intracranial aneurysms with the Woven EndoBridge device: a propensity score–matched study

Dibas

Adeeb

Diestro

et al. 2022

Journal of Neurosurgery

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OBJECTIVE Transradial access (TRA) is commonly utilized in neurointerventional procedures. This study compared the technical and clinical outcomes of the use of TRA versus those of transfemoral access (TFA) for intracranial aneurysm embolization with the Woven EndoBridge (WEB) device. METHODS This is a secondary analysis of the Worldwide WEB Consortium, which comprises multicenter data related to adult patients with intracranial aneurysms who were managed with the WEB device. These aneurysms were categorized into two groups: those who were treated with TRA or TFA. Patient and aneurysm characteristics and technical and clinical outcomes were compared between groups. Propensity score matching (PSM) was used to match groups according to the following baseline characteristics: age, sex, subarachnoid hemorrhage, aneurysm location, bifurcation aneurysm, aneurysm with incorporated branch, neck width, aspect ratio, dome width, and elapsed time since the last follow-up imaging evaluation. RESULTS This study included 682 intracranial aneurysms (median [interquartile range] age 61.3 [53.0–68.0] years), of which 561 were treated with TFA and 121 with TRA. PSM resulted in 65 matched pairs. After PSM, both groups had similar characteristics, angiographic and functional outcomes, and rates of retreatment, thromboembolic and hemorrhagic complications, and death. TFA was associated with longer procedure length (median 96.5 minutes vs 72.0 minutes, p = 0.006) and fluoroscopy time (28.2 minutes vs 24.8 minutes, p = 0.037) as compared with TRA. On the other hand, deployment issues were more common in those treated with TRA, but none resulted in permanent complications. CONCLUSIONS TRA has comparable outcomes, with shorter procedure and fluoroscopy time, to TFA for aneurysm embolization with the WEB device.

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Section: Discussionmentioning

confidence: 99%

“…[11][12][13] Only limited case series and case reports have attempted to investigate the efficacy and safety of TRA for WEB embolization of cerebral aneurysms. [14][15][16][17][18] In this large multicenter study, we used propensity score matching (PSM) to explore differences in technical and clinical outcomes between TRA and TFA for WEB embolization.…”

mentioning

confidence: 99%

Transradial versus transfemoral access for embolization of intracranial aneurysms with the Woven EndoBridge device: a propensity score–matched study

Dibas

Adeeb

Diestro

et al. 2022

Journal of Neurosurgery

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“…Several studies have reported the use of the DRA in neuroendovascular treatment, as shown in Table 3. [17][18][19][20][21][22][23][24][25] The DRA has been used to treat various diseases, including aneurysms, cerebral arteriovenous malformations, dural arteriovenous fistulas, carotid artery stenosis, and acute cerebral infarction. The guiding sheath is selected from amongst 4-to 6-Fr systems, except for one case where a 7-Fr system was used.…”

Section: Discussionmentioning

confidence: 99%

Distal radial artery approach is safe and effective for cerebral angiography and neuroendovascular treatment: A single-center experience with ultrasonographic measurement

et al. 2022

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Background The transradial artery approach to cerebral angiography can reduce both patient stress following examination and the risk of major complications due to hematoma. Recently, the distal radial artery approach (DRA) has garnered attention in cardiology as a minimally invasive method. DRA is also considered applicable to neurosurgery, although concerns about procedural difficulty and complications persist. Therefore, this study aimed to evaluate the efficacy of the DRA in cerebral angiography and neuroendovascular treatment. Methods We retrospectively selected 30 consecutive patients for whom the DRA was attempted for cerebral angiography at our hospital. The patients’ age, sex, height, weight, and medical history information was collected and correlated with successful puncture and complications. The diameter of the distal radial artery (RA) was measured using ultrasonography. Results The median patient age was 67 years (range, 32–87 years) and 21 (70%) were men. The median diameter of the distal RA was 2.3 mm (range, 1.7–3.2 mm). Distal RA puncture was successful in 23 patients (77%) and no complications were noted; however there was no significant correlation between successful puncture and any of the patient factors. Carotid artery stenting and preoperative tumor embolization were performed via DRA in six and three cases, respectively. Although puncture site hematoma occurred in only one case, all treatments were successful, and no major complications were observed. Conclusion DRA can be safely used for cerebral angiography and neuroendovascular treatment.

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The Woven EndoBridge (WEB) Device for the Treatment of Intracranial Aneurysms: Ten Years of Lessons Learned and Adjustments in Practice from the WorldWideWEB Consortium

Dmytriw

Dibas

Ghozy

et al. 2022

Transl. Stroke Res.

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Distal radial artery (Snuffbox) access for intracranial aneurysm treatment using the Woven EndoBridge (WEB) device

Cited by 11 publications

References 25 publications

Transradial versus transfemoral access for embolization of intracranial aneurysms with the Woven EndoBridge device: a propensity score–matched study

Transradial versus transfemoral access for embolization of intracranial aneurysms with the Woven EndoBridge device: a propensity score–matched study

Distal radial artery approach is safe and effective for cerebral angiography and neuroendovascular treatment: A single-center experience with ultrasonographic measurement

The Woven EndoBridge (WEB) Device for the Treatment of Intracranial Aneurysms: Ten Years of Lessons Learned and Adjustments in Practice from the WorldWideWEB Consortium

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