title: Selective use of transradial access for endovascular treatment of severe intracranial vertebrobasilar artery stenosis.
abstract: OBJECTIVE
  To study the feasibility and safety of transradial artery access for endovascular intervention of severe intracranial vertebrobasilar stenosis for selected patients not suitable for transfemoral access.
  
  
  METHODS
  This was a retrospective analysis of 58 patients who had undergone intervention for severe intracranial vertebrobasilar stenosis using transradial access between January 2012 and September 2014. The reasons for transradial access were traced. The outcome measures were the technical success rate, 30-day stroke or death in the territory of the culprit artery, periprocedural and access site complication rates.
  
  
  RESULTS
  Out of the 58 patients, 19 patients (32.8%) used the transradial approach due to poor iliofemoral artery access, 28 (48.3%) due to unfavorable brachiocephalic or subclavian artery anatomy, 11 (19%) due to unfavorable vertebral artery anatomy. The technical success rate was 100%. There were four periprocedural complications, one of which was asymptomatic. The 30-day stroke rate was 5.2% (3/58 patients), with two of them having no residual neurological deficits. There was no mortality. None had access site complications.
  
  
  CONCLUSIONS
  For selected patients with severe intracranial vertebrobasilar stenosis with difficult femoral access or anatomical variations precluding provision of a stable support for intracranial intervention, the transradial approach was shown to be a safe and feasible alternative route of access. Future trials of endovascular treatment for intracranial posterior circulation strokes should take into account the route of access.
authors.affiliation: Department of Interventional Neurology, Beijing Tiantan Hospital, Capital Medical University, 6 Tiantan Xili, Dongcheng District, Beijing 100050, China; China National Clinical Research Center for Neurological Diseases, 6 Tiantan Xili, Dongcheng District, Beijing 100050, China; Center of Stroke, Beijing Institute for Brain Disorders, 6 Tiantan Xili, Dongcheng District, Beijing 100050, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Gao
authors.affiliation: Department of Medicine, Queen Elizabeth Hospital, 30 Gascoigne Road, Kowloon, Hong Kong.
authors.forename: WaiTing Joyce
authors.initials: WJ
authors.lastname: Lo
authors.affiliation: Department of Interventional Neurology, Beijing Tiantan Hospital, Capital Medical University, 6 Tiantan Xili, Dongcheng District, Beijing 100050, China; China National Clinical Research Center for Neurological Diseases, 6 Tiantan Xili, Dongcheng District, Beijing 100050, China; Center of Stroke, Beijing Institute for Brain Disorders, 6 Tiantan Xili, Dongcheng District, Beijing 100050, China.
authors.forename: Xuan
authors.initials: X
authors.lastname: Sun
authors.affiliation: Department of Interventional Neurology, Beijing Tiantan Hospital, Capital Medical University, 6 Tiantan Xili, Dongcheng District, Beijing 100050, China; China National Clinical Research Center for Neurological Diseases, 6 Tiantan Xili, Dongcheng District, Beijing 100050, China; Center of Stroke, Beijing Institute for Brain Disorders, 6 Tiantan Xili, Dongcheng District, Beijing 100050, China.
authors.forename: Ning
authors.initials: N
authors.lastname: Ma
authors.affiliation: Department of Interventional Neurology, Beijing Tiantan Hospital, Capital Medical University, 6 Tiantan Xili, Dongcheng District, Beijing 100050, China; China National Clinical Research Center for Neurological Diseases, 6 Tiantan Xili, Dongcheng District, Beijing 100050, China; Center of Stroke, Beijing Institute for Brain Disorders, 6 Tiantan Xili, Dongcheng District, Beijing 100050, China.
authors.forename: DaPeng
authors.initials: D
authors.lastname: Mo
authors.affiliation: Department of Interventional Neurology, Beijing Tiantan Hospital, Capital Medical University, 6 Tiantan Xili, Dongcheng District, Beijing 100050, China; China National Clinical Research Center for Neurological Diseases, 6 Tiantan Xili, Dongcheng District, Beijing 100050, China; Center of Stroke, Beijing Institute for Brain Disorders, 6 Tiantan Xili, Dongcheng District, Beijing 100050, China.
authors.forename: XiaoTong
authors.initials: X
authors.lastname: Xu
authors.affiliation: Department of Interventional Neurology, Beijing Tiantan Hospital, Capital Medical University, 6 Tiantan Xili, Dongcheng District, Beijing 100050, China; China National Clinical Research Center for Neurological Diseases, 6 Tiantan Xili, Dongcheng District, Beijing 100050, China; Center of Stroke, Beijing Institute for Brain Disorders, 6 Tiantan Xili, Dongcheng District, Beijing 100050, China. Electronic address: zhongrongm@163.com.
authors.forename: ZhongRong
authors.initials: Z
authors.lastname: Miao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000379:methods*; D001013:Aorta, Thoracic / Q000002:abnormalities / Q000000981:diagnostic imaging; D001488:Basilar Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D016122:Brachiocephalic Trunk / Q000002:abnormalities / Q000000981:diagnostic imaging; D002406:Catheterization, Peripheral / Q000379:methods; D002533:Cerebral Angiography; D015331:Cohort Studies; D003251:Constriction, Pathologic / Q000628:therapy; D057510:Endovascular Procedures / Q000379:methods; D005240:Feasibility Studies; D005263:Femoral Artery / Q000002:abnormalities / Q000000981:diagnostic imaging; D006801:Humans; D007083:Iliac Artery / Q000002:abnormalities / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011183:Postoperative Complications; D017534:Radial Artery; D012189:Retrospective Studies; D015607:Stents; D013348:Subclavian Artery / Q000002:abnormalities / Q000000981:diagnostic imaging; D016896:Treatment Outcome; D014711:Vertebral Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D014715:Vertebrobasilar Insufficiency / Q000000981:diagnostic imaging / Q000628:therapy*
chemical_list: D010975:Platelet Aggregation Inhibitors
keywords: Angioplasty; Endovascular; Radial artery; Stenosis; Transradial