• Bernard R Bendok, Jason H Przybylo, Richard Parkinson, Yin Hu, Issam A Awad, and H Hunt Batjer.
• Department of Neurological Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611, USA. bbendok@nmff.org
• Neurosurgery. 2005 Mar 1;56(3):E626; discussion E626.

Objective And ImportanceTo describe our experience with the transradial approach for posterior circulation neurointerventional procedures. To the best of our knowledge, this approach has not been described previously for intracranial neuroendovascular procedures.Clinical PresentationThe clinical and imaging characteristics as well as periprocedural outcomes of patients treated for intracranial posterior circulation disease via the transradial approach were analyzed retrospectively.InterventionBetween January 1 and October 21, 2003, four patients with posterior circulation disease (aneurysm, n = 1, and atherosclerotic stenosis, n = 3) were treated via the transradial approach because of tortuous brachiocephalic anatomy. Procedural success was 100%, and there were no procedural complications. No technical difficulties were encountered.ConclusionThe transradial approach is an alternative to the femoral approach for posterior circulation neuroendovascular intervention. This approach has several advantages over other approaches, and the vasculature can be less tortuous than that encountered during the femoral approach. These factors can result in increased device trackability and procedural ease.

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