• World Neurosurg · Mar 2023

    Review

    Transradial mechanical thrombectomy using a radial-specific neurointerventional guiding sheath for anterior circulation large-vessel occlusions: Preliminary experience and literature review.

    • Masafumi Kuroiwa, Yoshiki Hanaoka, Jun-Ichi Koyama, Daisuke Yamazaki, Yuki Kubota, Satoshi Kitamura, Shunsuke Ichinose, Takuya Nakamura, Takaaki Kamijo, Yu Fujii, Toshihiro Ogiwara, Takahiro Murata, and Tetsuyoshi Horiuchi.
    • Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan; Department of Neurosurgery, Shinonoi General Hospital, Nagano, Japan.
    • World Neurosurg. 2023 Mar 1; 171: e581e589e581-e589.

    BackgroundTransradial mechanical thrombectomy (MT) is increasingly used because it is associated with a low incidence of vascular access site complications. However, transradial carotid cannulation can be technically challenging to perform in patients with an unfavorable supra-aortic takeoff. In this study, the feasibility and safety of a new transradial MT system with a radial-specific neurointerventional guiding sheath-6F Simmons guiding sheath was evaluated-in patients with anterior circulation large-vessel occlusions. Additionally, a literature review was performed.MethodsWe retrospectively analyzed data from our institutional database about consecutive patients who underwent transradial MT for anterior circulation large-vessel occlusion. After the 6F Simmons guiding sheath was engaged into the target common carotid artery, a triaxial system (Simmons guiding sheath/aspiration catheter/microcatheter), was established. MT using the continuous aspiration prior to intracranial vascular embolectomy technique was performed. Then, procedural success rate, successful revascularization, and procedure-related complications were assessed.ResultsA total of 13 patients who had transradial MT were included in the analysis. All 13 patients underwent successful thrombectomy without catheter kinking or system instability, and 12 of them achieved successful revascularization (modified Thrombolysis in Cerebral Infarction score of ≥2b). No complications occurred.ConclusionsTo the best of our knowledge, this is the first case series on transradial MT using a radial-specific neurointerventional system for anterior circulation large-vessel occlusions. This method may increase the success rate of transradial MT. Based on our initial experience, transradial MT, using this system, was feasible and safe for anterior circulation large-vessel occlusions.Copyright © 2022 Elsevier Inc. All rights reserved.

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