Trans-Distal Radial Artery Carotid Revascularization with Forearm Flow Reversal: An Alternative Option of CAS in the TCAR Era

Sato, Daisuke; Umekawa, Motoyuki; Koizumi, Satoshi; Ishigami, Daiichiro; Kiyofuji, Satoshi; Saito, Nobuhito

doi:10.1016/j.wneu.2024.01.058

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2024

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Cited by 2 publications

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Feasibility and radial artery occlusion rate of sheathless distal transradial access using balloon guide catheters

Onodera,

Yoshimura,

Azekami

et al. 2024

Neurosurg Rev

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Feasibility and radial artery occlusion rate of sheathless distal transradial access using balloon guide catheters

Onodera,

Yoshimura,

Azekami

et al. 2024

Neurosurg Rev

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Feasibility and Radial Artery Occlusion Rate of Sheathless Distal Transradial Access Using Balloon Guide Catheters

Onodera,

Yoshimura,

Azekami

et al. 2024

Preprint

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Objectives Distal transradial access (dTRA), performed through an anatomical snuffbox, minimizes post-procedural burdens of endovascular treatments. However, despite the benefits of balloon-guide catheters (BGCs), their use in dTRA is limited by their small radial artery diameter. Herein, we evaluated the feasibility and radial artery occlusion (RAO) rate of 8Fr BGCs used in sheathless dTRA. Materials and Methods This retrospective study reviewed patients treated with sheathless dTRA using an 8Fr Optimo at a single center between July 2023 and May 2024. dTRA procedures were performed under general anesthesia in patients not requiring urgent treatment. The RAO was assessed using ultrasonography 24 h after the procedure. The demographic and procedural characteristics were compared between the radial artery patency and occlusion groups. Results Of 170 patients, 50 underwent dTRA, and 43 (86%) completed the procedure. RAO occurred in 12/43 (28%) patients with dTRA. Univariate and receiver operating characteristic curve analyses demonstrated that the median radial artery diameter was significantly smaller in the RAO group (P < 0.001), with an optimal cut-off value of 2.4 mm to predict RAO. Complications included minor cerebral ischemia in two patients, but no severe ischemia was observed. Conclusions Sheathless dTRA using an 8Fr Optimo BGC is feasible, but the risk of RAO should be noted, particularly in patients with small radial artery diameters. This study suggests a radial artery diameter cutoff value of 2.4 mm to predict RAO, aiding access decisions for large-bore BGC. Further multicenter prospective studies are warranted to confirm these findings and assess long-term outcomes.

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Trans-Distal Radial Artery Carotid Revascularization with Forearm Flow Reversal: An Alternative Option of CAS in the TCAR Era

Cited by 2 publications

References 52 publications

Feasibility and radial artery occlusion rate of sheathless distal transradial access using balloon guide catheters

Feasibility and radial artery occlusion rate of sheathless distal transradial access using balloon guide catheters

Feasibility and Radial Artery Occlusion Rate of Sheathless Distal Transradial Access Using Balloon Guide Catheters

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