Radial Access for Neurointerventions

Abstract

Transradial access (TRA) has become the standard approach for cardiac intervention, with a large body of evidence demonstrating a lower incidence of vascular complications, better patient experience and cost reduction. There has been increasing interest in using TRA both for diagnostic neuroangiography and for interventional neurovascular procedures. This aim of this article is to discuss the advantages and limitations of TRA for neurointerventions. General technical details, such as pre-procedure recommendations, prevention of spasm and occlusion, haemostasis protocols and distal TRA puncture, are also described, along with the specific technical details of TRA for aneurysm embolisation, stroke thrombectomy and other neurovascular interventions. TRA provides additional tools to the neurointerventionist and – with appropriate training – the whole spectrum of intervention procedures can be achieved using this approach.