Feasibility and initial experience of left radial approach for diagnostic neuroangiography
Abstract Neuroangiography has seen a recent shift from transfemoral to transradial access. In transradial neuroangiography, the right dominant hand is the main access used. However, the left side may be used specifically for left posterior circulation pathologies and when right access cannot be used...
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2021
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oai:doaj.org-article:938ba7ba83f141af8e6b7b8a3fb556852021-12-02T14:12:45ZFeasibility and initial experience of left radial approach for diagnostic neuroangiography10.1038/s41598-020-80064-z2045-2322https://doaj.org/article/938ba7ba83f141af8e6b7b8a3fb556852021-01-01T00:00:00Zhttps://doi.org/10.1038/s41598-020-80064-zhttps://doaj.org/toc/2045-2322Abstract Neuroangiography has seen a recent shift from transfemoral to transradial access. In transradial neuroangiography, the right dominant hand is the main access used. However, the left side may be used specifically for left posterior circulation pathologies and when right access cannot be used. This study describes our initial experience with left radial access for diagnostic neuroangiography and assesses the feasibility and safety of this technique. We performed a retrospective review of a prospective database of consecutive patients between April 2018 and January 2020, and identified 20 patients whom a left radial access was used for neurovascular procedures. Left transradial neuroangiography was successful in all 20 patients and provided the sought diagnostic information; no patient required conversion to right radial or femoral access. Pathology consisted of anterior circulation aneurysms in 17 patients (85%), brain tumor in 1 patient (5%), and intracranial atherosclerosis disease involving the middle cerebral artery in 2 patients (10%). The left radial artery was accessed at the anatomic snuffbox in 18 patients (90%) and the wrist in 2 patients (10%). A single vessel was accessed in 7 (35%), two vessels in 8 (40%), three vessels in 4 (20%), and four vessels in 1 (5%). Catheterization was successful in 71% of the cases for the right internal carotid artery and in only 7.7% for the left internal carotid artery. There were no instances of radial artery spasm, radial artery occlusion, or procedural complications. Our initial experience found the left transradial access to be a potentially feasible approach for diagnostic neuroangiography even beyond the left vertebral artery. The approach is strongly favored by patients but has significant limitations compared with the right-sided approach.Nohra ChalouhiAhmad SweidFadi Al SaieghKalyan C. SajjaRichard F. SchmidtMichael B. AveryNikolaos MouchtourisOmaditya KhannaJoshua H. WeinbergVictor RomoStavropoula TjoumakarisMichael Reid GoochNabeel HerialRobert H. RosenwasserPascal JabbourNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-7 (2021) |
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Medicine R Science Q Nohra Chalouhi Ahmad Sweid Fadi Al Saiegh Kalyan C. Sajja Richard F. Schmidt Michael B. Avery Nikolaos Mouchtouris Omaditya Khanna Joshua H. Weinberg Victor Romo Stavropoula Tjoumakaris Michael Reid Gooch Nabeel Herial Robert H. Rosenwasser Pascal Jabbour Feasibility and initial experience of left radial approach for diagnostic neuroangiography |
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Abstract Neuroangiography has seen a recent shift from transfemoral to transradial access. In transradial neuroangiography, the right dominant hand is the main access used. However, the left side may be used specifically for left posterior circulation pathologies and when right access cannot be used. This study describes our initial experience with left radial access for diagnostic neuroangiography and assesses the feasibility and safety of this technique. We performed a retrospective review of a prospective database of consecutive patients between April 2018 and January 2020, and identified 20 patients whom a left radial access was used for neurovascular procedures. Left transradial neuroangiography was successful in all 20 patients and provided the sought diagnostic information; no patient required conversion to right radial or femoral access. Pathology consisted of anterior circulation aneurysms in 17 patients (85%), brain tumor in 1 patient (5%), and intracranial atherosclerosis disease involving the middle cerebral artery in 2 patients (10%). The left radial artery was accessed at the anatomic snuffbox in 18 patients (90%) and the wrist in 2 patients (10%). A single vessel was accessed in 7 (35%), two vessels in 8 (40%), three vessels in 4 (20%), and four vessels in 1 (5%). Catheterization was successful in 71% of the cases for the right internal carotid artery and in only 7.7% for the left internal carotid artery. There were no instances of radial artery spasm, radial artery occlusion, or procedural complications. Our initial experience found the left transradial access to be a potentially feasible approach for diagnostic neuroangiography even beyond the left vertebral artery. The approach is strongly favored by patients but has significant limitations compared with the right-sided approach. |
format |
article |
author |
Nohra Chalouhi Ahmad Sweid Fadi Al Saiegh Kalyan C. Sajja Richard F. Schmidt Michael B. Avery Nikolaos Mouchtouris Omaditya Khanna Joshua H. Weinberg Victor Romo Stavropoula Tjoumakaris Michael Reid Gooch Nabeel Herial Robert H. Rosenwasser Pascal Jabbour |
author_facet |
Nohra Chalouhi Ahmad Sweid Fadi Al Saiegh Kalyan C. Sajja Richard F. Schmidt Michael B. Avery Nikolaos Mouchtouris Omaditya Khanna Joshua H. Weinberg Victor Romo Stavropoula Tjoumakaris Michael Reid Gooch Nabeel Herial Robert H. Rosenwasser Pascal Jabbour |
author_sort |
Nohra Chalouhi |
title |
Feasibility and initial experience of left radial approach for diagnostic neuroangiography |
title_short |
Feasibility and initial experience of left radial approach for diagnostic neuroangiography |
title_full |
Feasibility and initial experience of left radial approach for diagnostic neuroangiography |
title_fullStr |
Feasibility and initial experience of left radial approach for diagnostic neuroangiography |
title_full_unstemmed |
Feasibility and initial experience of left radial approach for diagnostic neuroangiography |
title_sort |
feasibility and initial experience of left radial approach for diagnostic neuroangiography |
publisher |
Nature Portfolio |
publishDate |
2021 |
url |
https://doaj.org/article/938ba7ba83f141af8e6b7b8a3fb55685 |
work_keys_str_mv |
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