First line transradial access for posterior circulation stroke intervention; initial 12-month experience at a high volume thrombectomy center. (August 2020)

• Record Type: Journal Article
• Authors: Crockett, Matthew T.; Selkirk, Gregory D.; Chiu, Albert H.Y.; Singh, Tejinder P.; McAuliffe, William; Phillips, Timothy J.
• Is Part Of: Journal of clinical neuroscience. Volume 78(2020)
• Page Start: 194
• Page End: 197
• Publication Date: 2020-08
• Subjects: Thrombectomy -- Radial -- Posterior circulation -- Stroke; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2020.04.069
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: First line transradial access for posterior circulation stroke intervention was assessed. Data was prospectively collected for 12-months at a high volume thrombectomy center. Transradial access was successful in 96% of cases The median arteriotomy-reperfusion time was 24 minutes. Good angiographic outcome rate was 100%, good clinical outcome rate was 61%. No radial access site complications occurred. Abstract: Background: The Neurointerventional Surgery Standards and Guidelines Committee has advocated the use of transradial access in the setting of posterior circulation stroke intervention, however there is a paucity of published data on this approach. The purpose of this study is to present 12-months of prospectively collected data from a high volume thrombectomy center following the adoption of a first line transradial approach for posterior circulation stroke intervention. Methods: A range of data on patient characteristics, procedural metrics, complications and outcomes was prospectively collected between August 2018 - August 2019 following the adoption of first line transradial access for posterior circulation stroke intervention at a high volume thrombectomy center. Results: Transradial access was successful in 22/23 cases (96%), median arteriotomy to reperfusion time was 24 min (IQR 18–40), good angiographic outcome (mTICI 2b-3) was achieved in all cases and good clinical outcome (mRs 0–2) was achieved in 61% of cases. No intracranial or radial artery access site complications occurred. Conclusion: The fast procedure times, excellent outcomes and low complication rates achieved in this prospective 12-month study indicate that transradial access is a viable first line strategy in posterior circulation stroke intervention.