Transarterial and transvenous access for neurointerventional surgery: report of the SNIS Standards and Guidelines Committee

Starke, Robert M.; Snelling, Brian; Al‐Mufti, Fawaz; Gandhi, Chirag D.; Lee, Seon Kyu; Dabus, Guilherme; Fraser, Justin F.

doi:10.1136/neurintsurg-2019-015573

Cited by 42 publications

(38 citation statements)

References 106 publications

(128 reference statements)

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“…In addition, radial artery occlusion (RAO) may develop. 1) Thus, dTRA has recently become applied at a more peripheral site, mainly in the cardiovascular field, and favorable results have been reported (success rate of the procedure: 88%-98%, incidence of puncture-site complications: 0%-1%). 2) dTRA is a method of approaching through the deep palmar branch, a branch of the RA present in the anatomical snuffbox surrounded by the extensor pollicis longus and brevis muscle tendons 2) (Fig.…”

Section: Discussionmentioning

confidence: 99%

Distal Transradial Approach in Mechanical Thrombectomy: Technical Note

Tanoue¹,

Ono²,

Yoshiura³

et al. 2021

JNET

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Objective We report a case of mechanical thrombectomy (MT) via the distal transradial approach (dTRA) and technical tips. Case Presentation An 89-year-old woman was transferred to our hospital due to back pain after a fall and sudden-onset left hemiparesis. We performed MT because three-dimensional computed tomography angiography (3D-CTA) revealed right middle cerebral artery (MCA) occlusion. The access route was Type 3 aortic arch. The abdominal aorta and common iliac artery were tortuous and partially dissected, and she had a lumbar vertebra fracture. We selected dTRA in consideration of safety, ease of access, and less postoperative postural restriction. The first pass resulted in complete recanalization using an aspiration catheter and stent retriever. Her symptoms rapidly improved and she was discharged with a modified Rankin Scale score of 1. Conclusion dTRA in MT may be a treatment option.

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Section: Discussionmentioning

confidence: 99%

Distal Transradial Approach in Mechanical Thrombectomy: Technical Note

Tanoue¹,

Ono²,

Yoshiura³

et al. 2021

JNET

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“…Our technique adheres to described best practices for transvenous access: ultrasound-guided access, systemic heparin administration, and closure with manual compression. 15 The patient is positioned with the arm on an articulated arm board, which allows the arm to be turned in closer to the body after venous access is achieved. We widely prep the medial aspect of the arm, from axilla to elbow.…”

Section: Methodsmentioning

confidence: 99%

Single arm access venous sinus stenting (SAVeS) technique: Technical note

et al. 2020

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Intracranial venous sinus stenting is gaining acceptance as an effective treatment for idiopathic intracranial hypertension (IIH). The typical approach is via femoral venous and arterial access for transvenous stenting with simultaneous angiography. These patients are at an above average risk for groin complications considering obesity is typically associated with IIH and the need for heparinization and dual antiplatelet therapy. Here, we describe cerebral venography, angiography, and venous sinus stenting via a single upper extremity. We utilize a transradial approach for angiography and a venous access via the brachial or basilic vein. Over a series of 28 consecutive procedures, we were able to successfully access the intracranial venous sinuses via the arm without access site complications. This method offers the advantages of immediate patient mobilization after the procedure and more easily monitored and compressible access sites for easier post-procedural care.

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“…Interventional surgery with improper location of venous access has certain risks, especially coronary intervention and nerve intervention [6]. Patients may suffer from sudden drop in blood pressure, heart rate or even cardiac arrest at any time.…”

Section: Improper Location Of Venous Accessmentioning

confidence: 99%