For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
7
views
11
references
 Top references
cited by
22
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      639
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: not found

      Transradial approach for mechanical thrombectomy in anterior circulation large-vessel occlusion

      Read this article at

      ScienceOpenPublisher
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          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.

          Related collections

          Most cited references11

          • Record: found
          • Abstract: found
          • Article: not found

          Acute Ischemic Stroke Intervention.

          Ralph Sacco, Dileep R Yavagal, Priyank Khandelwal (2016)
          Acute ischemic stroke (AIS) is the leading cause of disability worldwide and among the leading causes of mortality. Although intravenous tissue plasminogen activator (IV-rtPA) was approved nearly 2 decades ago for treatment of AIS, only a minority of patients receive it due to a narrow time window for administration and several contraindications to its use. Endovascular approaches to recanalization in AIS developed in the 1980s, and recently, 5 major randomized trials showed an overwhelming superior benefit of combining endovascular mechanical thrombectomy with IV-rtPA over IV-rtPA alone. In this paper, we discuss the evolution of catheter-based treatment from first-generation thrombectomy devices to the game-changing stent retrievers, results from recent trials, and the evolving stroke systems of care to provide timely access to acute stroke intervention to patients in the United States.
          Article 0 comments Cited 70 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Evaluation of the ulnopalmar arterial arches with pulse oximetry and plethysmography: comparison with the Allen's test in 1010 patients.

            G Barbeau, F Arsenault, Serge Simard … (2004)
            To avoid ischemic hand complications, the percutaneous transradial approach is only performed in patients with patent hand collateral arteries, which is usually evaluated with the modified Allen's test (MAT). This qualitative test measures the time needed for maximal palmar blush after release of the ulnar artery compression with occlusive pressure of the radial artery. The objectives were to evaluate the patency of the hand collateral arteries and to compare MAT with combined plethysmography (PL) and pulse oximetry (OX) tests before the percutaneous transradial approach. Patients referred to the catheterization laboratory were prospectively examined with MAT, PL, and OX tests. PL readings during radial artery compression were divided into 4 types: A, no damping; B, slight damping of pulse tracing; C, loss followed by recovery; or D, no recovery of pulse tracing within 2 minutes. OX results were either positive or negative. Results of both tests were compared in 1010 consecutive patients. MAT results < or =9 seconds on either hand were seen in 93.7% of patients. PL and OX types A, B, or C on either hand were seen in 98.5% of patients. On the basis of the MAT < or =9 seconds criteria, 6.3% of patients were excluded from the transradial approach, whereas with PL and OX types A, B, and C, only 1.5% of patients were excluded. There was more exclusion in men and with increasing age by using both methods. In the evaluation of hand collaterals, PL and OX were found to be more sensitive than MAT. When applied to transradial approach screening, only 1.5% of patients were not suitable candidates for the transradial approach.
            Article 0 comments Cited 65 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Difficult catheter access to the occluded vessel during endovascular treatment of acute ischemic stroke is associated with worse clinical outcome.

              Jorge Pagola, Marc Ribó, Alan Flores … (2013)
              During endovascular procedures for acute ischemic stroke, catheter access to the occluded vessel may be technically difficult or impossible. The aim of this study was to access the impact of difficult catheter access to target the carotid artery on clinical outcome. Anterior circulation stroke patients undergoing transfemoral endovascular procedures where studied. Patients were divided into four groups according to time from groin puncture to target carotid catheterization quartiles. Patients in quartile 4 (Q4) were considered difficult carotid access. We defined several outcome measures: recanalisation (final Thrombolysis in Cerebral Infarction score ≥ 2a), time from groin puncture to recanalisation and favorable long term outcome (modified Rankin Scale score 30 min) had lower rates of recanalization (60.7% vs 82.4%; p=0.02) and a lower favorable outcome (13.6% vs 41.3%; p=0.04). A logistic regression adjusted by age showed that baseline National Institutes of Health Stroke Scale score (OR 0.8; 95% CI: 0.72 to 0.92 p<0.01) and having difficult access (OR 1.3; 95% CI 1.3 to 20.1 p=0.018) independently predicted worse long term outcome. Difficult catheter access to target the carotid is common during acute endovascular treatment of stroke patients and is associated with a worse clinical outcome. If transfemoral access appears difficult, alternative access such as direct carotid puncture could be explored.
              Article 0 comments Cited 44 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Journal
                Title: Neurosurgical Focus
                Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
                ISSN (Electronic): 1092-0684
                Publication date Created: April 2017
                Publication date (Print): April 2017
                Page: E13
                Article
                DOI: 10.3171/2017.1.FOCUS16525
                SO-VID: 8963765c-f55e-44ba-b4d4-f724e04bd26e
                Copyright © © 2017
                History

                Data availability:

                Comments

                Comment on this article

                scite_

                Similar content639

                See all similar

                Cited by22

                See all cited by