Radial artery access with a sheathless 0.087" inner diameter balloon guide catheter (Walrus) for neurointerventional procedures: Technique and clinical outcomes

Intro: There is a growing preference among neurointerventionalists for transradial access (TRA) over transfemoral access (TFA) due to improved patient satisfaction, recovery time and reduced access site complication, but using balloon guide catheters (BGCs) in the radial artery remains a challenge. We report our experience in successfully using the 0.087" inner diameter Walrus BGC without a sheath via the radial artery for non-emergent neurointerventions.

Objective: Describe the technique for safely accessing the radial artery using the sheathless Walrus balloon guide catheter.

Methods: A retrospective chart review of thirteen consecutive patients who underwent intervention with radial artery access with a sheathless Walrus BGC was performed.

Results: All twelve procedures were performed successfully with no instances of conversion from TRA to TFA. There were no significant procedural or access site complications. The mean radial diameter was 2.51 mm.

Conclusions: The Walrus 0.087" ID BGC is an effective tool that can safely be used via the radial artery using a sheathless approach, which helps to maximize the size of the catheter that can be used. This is the first instance of our knowledge of this technique being utilized for neurointerventions and therefore could be used to expand the indications for TRA for a wider range of procedures.