Abstract:
BACKGROUND:Numerous large randomized trials have shown a significant morbidity and mortality benefit with the transradial approach (TRA) over the transfemoral approach (TFA) for endovascular procedures. However, this technique is routinely avoided or aborted due to unfamiliarity with the technique and the associated anatomical difficulties that may be faced in this approach. The objective of this review is to identify both the common and uncommon challenges that may be encountered during a transradial approach for cerebrovascular catheterization and to provide tips and tricks to overcome the transradial learning curve. METHOD:A careful review of the literature and of all our transradial cases was carried out to identify the common challenges and complications that are encountered when using TRA for diagnostic cerebral angiography and neurointerventions. RESULTS:A stepwise approach is provided to prevent and manage common challenges including radial artery access failure, radial artery spasm, radial artery anomalies and tortuosity, radial artery occlusion, radial artery perforation and hematoma, subclavian tortuosity and anomalies, and catheter knots and kinks. CONCLUSION:The ability to recognize and navigate anatomical variations and complications unique to TRA will accelerate learning, decrease unnecessary morbidity and mortality, and further advance the neurovascular field.
journal_name
J Neurointerv Surgjournal_title
Journal of neurointerventional surgeryauthors
Brunet MC,Chen SH,Peterson ECdoi
10.1136/neurintsurg-2019-015145subject
Has Abstractpub_date
2020-01-01 00:00:00pages
82-86issue
1eissn
1759-8478issn
1759-8486pii
neurintsurg-2019-015145journal_volume
12pub_type
杂志文章,评审abstract:BACKGROUND:Flow diversion is an important tool for treatment of cerebral aneurysms, particularly large and giant aneurysms. The Surpass flow diverter is a new system under evaluation in the USA. OBJECTIVE:To report our initial experience of 20 cases with the Surpass flow diverter to demonstrate its basic properties, t...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2015-011769
更新日期:2016-03-01 00:00:00
abstract::: Vessel wall magnetic resonance imaging (MRI) is a novel imaging technique that allows the intracranial vessel walls to be imaged directly. This state-of the art imaging modality may potentially change the way aneurysms are evaluated and managed. In this short review we discuss the current knowledge with illustrative...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章,评审
doi:10.1136/neurintsurg-2015-012130
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND AND PURPOSE:To report on the feasibility, safety, and outcome of acute intracranial stenting (ICS) with the Acclino (Flex) Stent and NeuroSpeed Balloon Catheter in cases of failed mechanical thrombectomy (MT) for acute ischemic stroke (AIS). METHODS:We retrospectively reviewed the data of patients treated w...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章,多中心研究
doi:10.1136/neurintsurg-2019-014957
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:The DEFUSE 3 and DAWN trials have shown the benefit of thrombectomy beyond 6 hours of stroke symptom onset in carefully selected patients. OBJECTIVE:To evaluate the real-world outcomes of stent retriever thrombectomy beyond 6 hours of stroke onset using combined individual patient data from the North Americ...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2018-014272
更新日期:2019-04-01 00:00:00
abstract:INTRODUCTION:Endovascular interventions for intracranial aneurysms have evolved substantially over the past several decades. A citation rank list is used to measure the scientific and/or clinical impact of an article. Our objective was to identify and analyze the characteristics of the 100 most cited articles in the fi...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2017-013688
更新日期:2018-09-01 00:00:00
abstract::Acute hemorrhage relating to an expanding pseudoaneurysm of the carotid artery is referred to as carotid blowout syndrome (CBS). CBS is associated with a high morbidity and mortality. We describe the case of a patient who presented with dysphagia and a pulsatile mass in the neck. Imaging revealed a pseudoaneurysm orig...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2015-012121.rep
更新日期:2016-12-01 00:00:00
abstract::Intravascular foreign bodies are a known complication of medical and dental procedures. Dental anesthetic needles may be broken off and retained in the oropharynx. These needles have occasionally been reported to migrate through the oral mucosa in to deeper structures. Here we present the case of a 57-year-old man who...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2016-012771.rep
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:The low profile visualized intraluminal support (LVIS) device is being increasingly used for the treatment of intracranial aneurysms. Its application in the basilar artery (BA) has not yet been reported. OBJECTIVE:To evaluate the safety and early efficacy of the LVIS device for the treatment of BA aneurysms...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2018-014393
更新日期:2019-04-01 00:00:00
abstract::The recognition of sacral insufficiency fractures continues to be poor, and diagnosis is often delayed resulting in significant morbidity. Percutaneous sacroplasty is an image guided procedure that is safe and potentially effective for treating the pain and disability related to these fractures. Several cohort studies...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章,评审
doi:10.1136/neurintsurg-2011-010136
更新日期:2012-09-01 00:00:00
abstract::The Solitaire (Medtronic Inc, Mansfield, Massachusetts, USA) is a stentriever device for endovascular treatment of acute ischemic stroke. Temporary endovascular bypass and mechanical thrombectomy are well-described applications of this device. However, few reports of permanent stent placement have been published. We p...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2017-013418
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVE:To elucidate the early detachment of the Solitaire stent during mechanical thrombectomy, we tested the stent in vitro under various conditions and evaluated with microscopy. METHODS:A total of five stents were tested. Using a dynamic mechanical analysis machine, we calculated the tensile force needed for sep...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2013-010942
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:Endovascular recanalization for medically refractory non-acute middle cerebral artery (MCA) occlusion remains a clinical dilemma, and limited data are available. We report the multicenter clinical results of endovascular recanalization for symptomatic non-acute MCA occlusion and propose a new angiographic cl...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2020-016692
更新日期:2020-10-29 00:00:00
abstract:BACKGROUND AND PURPOSE:The rabbit small clot embolic model for large vessel occlusion (LVO) is well established, yet has limitations. Blind introduction of autologous thrombus often fails to completely occlude a target vessel and, when successful, the precise timing of occlusion and revascularization is difficult to co...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2013-011063
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:Stenting of symptomatic intracranial atherosclerosis remains under investigation, yet this option to potentially avert subsequent stroke has been offered at select centers under humanitarian device exemption and off-label use for several years. METHODS:Retrospective case series of consecutive patients under...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/jnis.2010.004523
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:In acute stroke management, time efficiency in the continuum of patient management is critical. We aimed to determine if implementation of system improvements at our institution translated to reduced picture-to-puncture (P2P) times over a 6-year period. METHODS:We conducted a single-center retrospective ana...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2014-011177
更新日期:2015-08-01 00:00:00
abstract::A patient with a giant symptomatic vertebrobasilar aneurysm was treated by endoscopic third ventriculostomy for obstructive hydrocephalus followed by treatment of the aneurysm by flow diversion using a Pipeline Embolization Device. After an uneventful procedure and initial periprocedural period, the patient experience...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2014-011325.rep
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Reversible cerebral vasoconstriction syndromes (RCVS) represent a heterogeneous group of cerebrovascular disease characterized by acute presentations and transient segmental narrowing of the distal intracranial arteries. A series of patients with RCVS were studied to better understand the clinica...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/jnis.2010.004242
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:Randomized clinical trials have proven mechanical thrombectomy (MT) to be a highly effective and safe treatment in acute stroke. The purpose of this study was to compare neurothrombectomy data from the Czech Republic (CR) with data from the HERMES meta-analysis. METHODS:Available nationwide data for the CR ...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章,meta分析
doi:10.1136/neurintsurg-2017-013534
更新日期:2018-08-01 00:00:00
abstract::More than half a decade of experience and follow-up has now been accumulated with regard to flow diversion as a treatment for intracranial aneurysms; however, many uncertainties, such as the nature of aneurysmal remnants and the meaning of non-regressed, non-perfused aneurysmal masses, are still unknown. Here we discu...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2015-012093.rep
更新日期:2016-11-01 00:00:00
abstract:OBJECTIVE:To determine the relative effectiveness of proximal and distal protection in prevention of cerebral ischemic events during carotid artery stent (CAS) placement using diffusion-weighted MRI (DW-MRI). METHODS:We analyzed data from patients who had undergone DW-MRI before and within 24 hours of CAS for symptoma...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2016-012661
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:Due to anatomic features, including wide necks and incorporation of important branches, endovascular coiling of middle cerebral artery (MCA) aneurysms has proved challenging. Stent assisted embolization may increase the likelihood of successful treatment. METHODS:Consecutive patients undergoing stent assist...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2011-010162
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Towards the translation of computational fluid dynamics (CFD) techniques into the clinical workflow, performance increases achieved with parallel multi-central processing unit (CPU) pulsatile CFD simulations in a patient-derived model of a bilobed posterior communicating artery aneurysm were evaluated while ...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2012-010586
更新日期:2013-11-01 00:00:00
abstract::Retinoblastoma is a rare and curable malignancy affecting the pediatric population. For advanced stage intraocular retinoblastoma, enucleation remains the primary treatment modality, although the use of laser photocoagulation, cryotherapy, radiotherapy and chemotherapy are frequently used, particularly in the setting ...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2011-010019
更新日期:2012-07-01 00:00:00
abstract::The Cerebrovascular Center at the Cleveland Clinic is an integrated, multidisciplinary center comprising vascular neurologists, neurointensivists, physiatrists, open and endovascular neurosurgeons, interventional neurologists and interventional neuroradiologists administered through a single financial center with unif...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章,评审
doi:10.1136/jnis.2010.004101
更新日期:2012-03-01 00:00:00
abstract::The Massachusetts General Hospital Neuroradiology Division employed an experience and evidence based approach to develop a neuroimaging algorithm to best select patients with severe ischemic strokes caused by anterior circulation occlusions (ACOs) for intravenous tissue plasminogen activator and endovascular treatment...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章,评审
doi:10.1136/neurintsurg-2013-010715
更新日期:2013-05-01 00:00:00
abstract:OBJECTIVE:To investigate the working memory of patients with cervicocerebral artery stenosis and its change after stenting. METHODS:35 patients with cervicocerebral artery stenosis (≥50% with related symptoms of cerebral ischemia, or ≥70% with or without related symptoms of cerebral ischemia) underwent endovascular st...
journal_title:Journal of neurointerventional surgery
pub_type: 临床试验,杂志文章
doi:10.1136/neurintsurg-2013-010698
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The pCONus is a new stent featuring a distal end that opens like a blossoming flower with four petals. The device is implanted in the aneurysm sac at the level of the neck. We report our initial experience in a series of patients treated with this device. METHODS:This retrospective study was app...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2015-011898
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:Human placenta is a convenient resource for biomedical research, and has not yet been used for neurointerventional surgery research. OBJECTIVE:Our objective was to explore the feasibility of using human placenta to test various endovascular interventions and for training. DESIGN:18 placentas soon after del...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2013-010813
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:The transradial approach (TRA) reduces mortality, morbidity, access site complications, hospital cost, and length of stay while maximizing patient satisfaction. We aimed to assess the technical success and safety of TRA for elderly patients (aged ≥75 years). METHODS:A retrospective chart review and comparat...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2020-016140
更新日期:2020-12-01 00:00:00
abstract::Wide-necked bifurcation aneurysms (WNBAs) make up 26-36% of all brain aneurysms. Treatments for WNBAs pose unique challenges due to the need to preserve major bifurcation vessels while achieving a durable occlusion of the aneurysm. Intrasaccular flow disruption is an innovative technique for the treatment of WNBAs. Th...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章,评审
doi:10.1136/neurintsurg-2019-015506
更新日期:2020-05-01 00:00:00