title: Feasibility of the Transradial or the Transbrachial Approach in Various Neurointerventional Procedures.
abstract: OBJECTIVE
  The generally preferred vascular access for neurointerventional procedures is the transfemoral approach (TFA). In complicated cases such as patients with aortic diseases or tortuous vessels, transradial or transbrachial approaches (TRA or TBA) could be good alternatives. The purpose of this study is to review a single medical center experience using the alternative accesses.
  
  
  METHODS
  We reviewed the medical records of 30 TRA and 10 TBA cases among 2,073 cases treated between January 2010 and July 2013. We reviewed and analyzed the frequency of TRA and TBA, the reason the operator had chosen the TRA or TBA, the category of the procedure, caliber of the sheath, the success rate, and the complications rates.
  
  
  RESULTS
  The most common reason the non-TFA route was chosen was due to the patient's tortuous vascular system (n=24, 60%). The most common category of intervention was balloon angioplasty and/or stent placement (n=18, 45%). The largest caliber of the introducing sheath was 6 Fr in TRA and 7 Fr in TBA. Procedural success was achieved in 37 cases (success rate: 92.5%), and in three cases it failed. Six patients with complications were reported. Among them, four cases of minor complications (10%) occurred. There was no serious complication directly related to the access problem.
  
  
  CONCLUSIONS
  Both TRA and TBA can be good alternative access routes when TFA is not appropriate in various neurointervential procedures.
authors.affiliation: Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ; Department of Neurology, Sejong General Hospital, Bucheon, Korea.
authors.forename: Dong Geun
authors.initials: DG
authors.lastname: Lee
authors.affiliation: Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Deok Hee
authors.initials: DH
authors.lastname: Lee
authors.affiliation: Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ; Department of Radiology, Ulsan Hospital, Ulsan, Korea.
authors.forename: Jae Ho
authors.initials: JH
authors.lastname: Shim
authors.affiliation: Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Dae Chul
authors.initials: DC
authors.lastname: Suh
keywords: Endovascular technique; Therapeutic/methods; Transbrachial approach; Transfemoral approach; Transradial approach