Early experience with a novel 088 long sheath in transradial neurointerventions

Clin Neurol Neurosurg. 2021 Mar:202:106510. doi: 10.1016/j.clineuro.2021.106510. Epub 2021 Jan 20.

Abstract

Background: Transradial access (TRA) for neuroendovascular procedures has several clear benefits compared to transfemoral access. In this study, we report our initial experience with neuroendovascular procedures performed via transradial access using the novel Ballast 088 long sheath.

Methods: We conducted a retrospective analysis and identified 91 consecutive patients who underwent neuroendovascular procedures via TRA using the Ballast 088 long sheath. Data collection was performed on indication for procedure, number of vessels selectively catheterized, fluoroscopy time, procedure duration, radiation exposure, failure of radial access and conversion to transfemoral access, periprocedural complications, and procedural outcomes.

Results: Amongst 91 patients, the average age was 65.5 years ± 14.2 with 45 (49.5 %) female patients. 25 (27.5 %) patients underwent aneurysm treatment, 2 (2.2 %) AVM/AVF embolization, 28 (30.8 %) intracranial or extracranial stenting, 31 (34.1 %) stroke treatment, and 5 (5.5 %) underwent diagnostic angiogram. The mean number of target vessels catheterized was 1.07 ± 0.25, the mean procedure duration (minutes) was 96.5 ± 57.2, mean fluoroscopy time (minutes) was 21.9 ± 14.2, mean contrast dose (ml) was 112.7 ± 66.7, and mean radiation exposure (Gycm2) was 54.82 ± 41.37. The success rate of target vessel catheterization was 100 %. There were no complications resulting in long term sequelae. Access complications occurred in 1 (1.1 %) patients. Transfemoral conversion was required in 3 (3.3 %) patients.

Conclusions: The Ballast 088 long sheath is safe and effective for TRA in neuroendovascular procedures with a low rate of complications and conversion.

Keywords: Endovascular; Long sheath; Neurointervention; Radial artery; Transradial access.

MeSH terms

  • Aged
  • Arteriovenous Fistula / surgery*
  • Cerebral Angiography
  • Endovascular Procedures / instrumentation*
  • Endovascular Procedures / methods
  • Female
  • Fluoroscopy
  • Humans
  • Intracranial Aneurysm / surgery*
  • Intracranial Arteriovenous Malformations / surgery*
  • Male
  • Middle Aged
  • Neurosurgical Procedures / instrumentation*
  • Neurosurgical Procedures / methods
  • Operative Time
  • Postoperative Complications / epidemiology
  • Radial Artery*
  • Radiation Exposure
  • Retrospective Studies
  • Stroke / surgery*
  • Vascular Access Devices*