What question did this study set out to answer?

Address technical hurdles in transradial neurointerventions, specifically catheter instability and kinking in anterior circulation targets with unfavorable vessel angles.

July 1, 2021Neurosurgery

Letter: Lessons Learned After 760 Neurointerventions via the Upper Extremity Vasculature: Pearls and Pitfalls

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Authors

YHYoshiki HanaokaSoma Central Hospital JKJun-ichi KoyamaObayashi (Japan)TOToshihiro OgiwaraKanazawa Medical University

Discussion

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Implication

Clinical commentary observes preshaped Simmons guiding sheaths enhance carotid cannulation during transradial neurointerventions, highlighting technical strategies for steep vascular takeoffs.

Key Points

Address technical hurdles in transradial neurointerventions, specifically catheter instability and kinking in anterior circulation targets with unfavorable vessel angles.
Evaluation of a radial-first approach using a 6F preshaped Simmons guiding sheath (Axcelguide Stiff-J) for therapeutic neurointerventions.
Deployment of carotid cannulation maneuvers using either a push-in technique or a pull-back technique following Simmons curve reformation via descending aorta anchoring (DAT) or subclavian artery anchoring (SCAT).
The 6F preshaped Simmons guiding sheath maintained a large-bore working channel (0.088-inch inner diameter) without catheter kinking or herniation into the aortic arch across diverse arch anatomies.
The push-in maneuver effectively engaged favorable anatomies, while the pull-back technique enabled reliable cannulation in challenging steep takeoffs, such as nonbovine left common carotid artery lesions.

Cite This Study

Hanaoka et al. (2021) studied this question.

synapsesocial.com/papers/6a9d7b19651e357600bf12da https://doi.org/10.1093/neuros/nyab271

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Implication

Clinical commentary observes preshaped Simmons guiding sheaths enhance carotid cannulation during transradial neurointerventions, highlighting technical strategies for steep vascular takeoffs.

Letter: Lessons Learned After 760 Neurointerventions via the Upper Extremity Vasculature: Pearls and Pitfalls

Discussion

Member takes

Implication

Key Points

Cite This Study

Letter: Lessons Learned After 760 Neurointerventions via the Upper Extremity Vasculature: Pearls and Pitfalls

Discussion

Member takes

Implication

Key Points

Cite This Study

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