title: Transradial approach for mechanical thrombectomy in anterior circulation large-vessel occlusion.
abstract: OBJECTIVE The goals of this study were to describe the authors' recent institutional experience with the transradial approach to anterior circulation large-vessel occlusions (LVOs) in acute ischemic stroke patients and to report its technical feasibility. METHODS The authors reviewed their institutional database to identify patients who underwent mechanical thrombectomy via a transradial approach over the 2 previous years, encompassing their experience using modern techniques including stent retrievers. RESULTS Eleven patients were identified. In 8 (72%) of these patients the right radial artery was chosen as the primary access site. In the remaining patients, transfemoral access was initially attempted. Revascularization (modified Treatment in Cerebral Ischemia [mTICI] score ≥ 2b) was achieved in 10 (91%) of 11 cases. The average time to first pass with the stent retriever was 64 minutes. No access-related complications occurred. CONCLUSIONS Transradial access for mechanical thrombectomy in anterior circulation LVOs is safe and feasible. Further comparative studies are needed to determine criteria for selecting the transradial approach in this setting.
authors.affiliation: Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Samir
authors.initials: S
authors.lastname: Sur
authors.affiliation: Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Brian
authors.initials: B
authors.lastname: Snelling
authors.affiliation: Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Priyank
authors.initials: P
authors.lastname: Khandelwal
authors.affiliation: Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Justin M
authors.initials: JM
authors.lastname: Caplan
authors.affiliation: Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Eric C
authors.initials: EC
authors.lastname: Peterson
authors.affiliation: Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Starke
authors.affiliation: Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Dileep R
authors.initials: DR
authors.lastname: Yavagal
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D008297:Male; D020521:Stroke / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D017131:Thrombectomy / Q000295:instrumentation* / Q000379:methods*; D015912:Thrombolytic Therapy / Q000379:methods*; D016896:Treatment Outcome
keywords: AIS; CCA = common carotid artery; EVT; ICA = internal carotid artery; LVO = large-vessel occlusion; acute ischemic stroke; endovascular therapy; large-vessel occlusion; mTICI = modified Treatment in Cerebral Ischemia; thrombectomy; transradial