Volume 3, Issue 3 (12-2017)                   IrJNS 2017, 3(3): 119-123 | Back to browse issues page

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Ghorbani M, Hejazian E. Transradial Neurointerventional Approach to Basilar Tip Aneurysm: Case Report and Technical Note. IrJNS. 2017; 3 (3) :119-123
URL: http://irjns.org/article-1-114-en.html
1- Division of Vascular and Endovascular Neurosurgery, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
2- MD Division of Vascular and Endovascular Neurosurgery, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran , sehbums@yahoo.com
Abstract:   (234 Views)
Cerebral angiography through transfemoral approach is preferred in most of the situation though in cardiovascular surgery transradial angiography is accounted as the superior standard. The present study aimed at presenting our early experience of transradial approach to cerebral angiography and intervention of a patient with basilar tip aneurysm that had inappropriate vasculature to perform routine transfemoral approach. The patient was a 65 year-old man with a large basilar tip aneurysm that was candidate for endosacular coiling through transfemoral route. But due to very tortuous iliac artery, aortic arch and its branches, navigation transfemorraly via both vertebral arteries was impossible. Therefore we decided to do the procedure through right transarterial route. The procedure was started by doing Allen`s test to confirm good perfusion of right hand by collateral arteries. After that cerebral angiography and neurointervention was done transradially without any complication. As a result, although a transradial approach is not a routine way for cerebral angiography and intervention, it can be used safely as an alternative way in specific cases.
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Type of Study: Case report | Subject: Skull Base

1. Agostoni P, Biondi-Zoccai GGL, De Benedictis ML, Rigattieri S, Turri M, Anselmi M, et al. Radial versus femoral approach for percutaneous coronary diagnostic and interventional procedures. Journal of the American College of Cardiology. 2004; 44(2):349–56. doi: 10.1016/j.jacc.2004.04.034 [DOI:10.1016/j.jacc.2004.04.034]
2. Bendok BR, Przybylo JH, Parkinson R, Hu Y, Awad IA, Batjer HH. Neuroendovascular interventions for intracranial posterior circulation disease via the transradial approach : technical case report. Neurosurgery. 2005; 56(3):E626–E626. doi: 10.1227/01.neu.0000154820.28342.38 [DOI:10.1227/01.NEU.0000154820.28342.38]
3. Hildick-Smith DJ., Lowe MD, Walsh JT, Ludman PF, Stephens NG, Schofield PM, et al. Coronary angiography from the radial artery – experience, complications and limitations. International Journal of Cardiology. 1998; 64(3):231–9. doi: 10.1016/s0167-5273(98)00074-6 [DOI:10.1016/S0167-5273(98)00074-6]
4. Kiemeneij F, Laarman GJ, Odekerken D, Slagboom T, van der Wieken R. A randomized comparison of percutaneous transluminal coronary angioplasty by the radial, brachial and femoral approaches: The access study. Journal of the American College of Cardiology. 1997; 29(6):1269–75. doi: 10.1016/s0735-1097(97)00064-8 [DOI:10.1016/S0735-1097(97)00064-8]
5. Kim JH, Park YS, Chung CG, Park KS, Chung DJ, Kim HJ. Feasibility and Utility of Transradial Cerebral Angiograpy: Experience during the Learning Period. Korean Journal of Radiology. 2006; 7(1):7. doi: 10.3348/kjr.2006.7.1.7 [DOI:10.3348/kjr.2006.7.1.7]
6. Lotan C, Hasin Y, Mosseri M, Rozenman Y, Admon D, Nassar H, et al. Transradial approach for coronary angiography and angioplasty. The American Journal of Cardiology. 1995; 76(3):164–7. doi: 10.1016/s0002-9149(99)80050-2 [DOI:10.1016/S0002-9149(99)80050-2]
7. Ludman PF, Stephens NG, Harcombe A, Lowe MD, Shapiro LM, Schofield PM, et al. Radial versus femoral approach for diagnostic coronary angiography in stable angina pectoris. The American Journal of Cardiology. 1997; 79(9):1239–41. doi: 10.1016/s0002-9149(97)00089-1. [DOI:10.1016/S0002-9149(97)00089-1]
8. Fessler RD, Wakhloo AK, Lanzino G, Guterman LR, Hopkins LN. Transradial approach for vertebral artery stenting: Technical case report. Neurosurgery. 2000; 46(6):1524–8. doi: 10.1097/00006123-200006000-00044 [DOI:10.1097/00006123-200006000-00044]
9. Iwasaki S, Yokoyama K, Takayama K, Ueda K, Sueyosi S, Nagasawa M, et al. The transradial approach for selective carotid and vertebral angiography. Acta Radiologica. 2002; 43(6):549–55. doi: 10.1034/j.1600-0455.2002.430601.x [DOI:10.1034/j.1600-0455.2002.430601.x]
10. Levy EI, Boulos AS, Fessler RD, Bendok BR, Ringer AJ, Kim SH, et al. Transradial Cerebral Angiography: An Alternative Route. Neurosurgery. 2002; 51(2):335–42. doi: 10.1097/00006123-200208000-00007 [DOI:10.1097/00006123-200208000-00007]
11. Nohara AM, Kallmes DF. Transradial cerebral angiography: Technique and outcomes. American Journal of Neuroradiology. 2003; 24(6):1247-50. PMID: 12812964 [PMID]
12. Wu CJ, Hung WC, Chen SM, Yang CH, Chen CJ, Cheng CI, et al. Feasibility and safety of transradial artery approach for selective cerebral angiography. Catheterization and Cardiovascular Interventions. 2005; 66(1):21–6. doi: 10.1002/ccd.20396 [DOI:10.1002/ccd.20396]
13. Sur S, Snelling B, Khandelwal P, Caplan JM, Peterson EC, Starke RM, et al. Transradial approach for mechanical thrombectomy in anterior circulation large-vessel occlusion. Neurosurgical Focus. 2017; 42(4):E13. doi: 10.3171/2017.1.focus16525 [DOI:10.3171/2017.1.FOCUS16525]
14. Campeau L. Percutaneous radial artery approach for coronary angiography. Catheterization and Cardiovascular Diagnosis. 1989; 16(1):3–7. doi: 10.1002/ccd.1810160103 [DOI:10.1002/ccd.1810160103]
15. Matsumoto Y, Hongo K, Toriyama T, Nagashima H, Kobayashi S. Transradial approach for diagnostic selective cerebral angiography: Results of a consecutive series of 166 cases. American Journal of Neuroradiology. 2001; 22(4):704-8. PMID: 11290482 [PMID]
16. Mendiz OA, Sampaolesi AH, Londero HF, Fava CM, Lev GA, Valdivieso LR. Initial Experience With Transradial Access for Carotid Artery Stenting. Vascular and Endovascular Surgery. 2011; 45(6):499–503. doi: 10.1177/1538574411405547 [DOI:10.1177/1538574411405547]
17. Esente P, Giambartolomei A, Simons AJ, Levy C, Caputo RP. Overcoming vascular anatomic challenges to cardiac catheterization by the radial artery approach: Specific techniques to improve success. Catheterization and Cardiovascular Interventions. 2002; 56(2):207–11. doi: 10.1002/ccd.10233 [DOI:10.1002/ccd.10233]
18. Valsecchi O, Vassileva A, Musumeci G, Rossini R, Tespili M, Guagliumi G, et al. Failure of transradial approach during coronary interventions: Anatomic considerations. Catheterization and Cardiovascular Interventions. 2006; 67(6):870–8. doi: 10.1002/ccd.20732 [DOI:10.1002/ccd.20732]
19. Benit E, Vranckx P, Jaspers L, Jackmaert R, Poelmans C, Coninx R. Frequency of a positive modified Allen's test in 1,000 consecutive patients undergoing cardiac catheterization. Catheterization and Cardiovascular Diagnosis. 1996; 38(4):352–54. https://doi.org/10.1002/(SICI)1097-0304(199608)38:4<352::AID-CCD5>3.0.CO;2-6 [DOI:10.1002/(SICI)1097-0304(199608)38:43.0.CO;2-6]
20. Lee DH, Ahn JH, Jeong SS, Eo KS, Park MS. Routine transradial access for conventional cerebral angiography: A single operator's experience of its feasibility and safety. The British Journal of Radiology. 2004; 77(922):831–38. doi: 10.1259/bjr/89933527 [DOI:10.1259/bjr/89933527]
21. Park SH, Park JC, Hwang JH, Hwang SK, Hamm IS. Role of Three-dimensional computed tomography angiography in the follow-up of patients with aneurysm clips. Journal of Korean Neurosurgical Society. 2006; 39:427–31.
22. Ricci MA, Trevisani GT, Pilcher DB. Vascular complications of cardiac catheterization. The American Journal of Surgery. 1994; 167(4):375–8. doi: 10.1016/0002-9610(94)90119-8 [DOI:10.1016/0002-9610(94)90119-8]
23. Kiemeneij F, Laarman GJ, de Melker E. Transradial artery coronary angioplasty. American Heart Journal. 1995; 129(1):1–7. doi: 10.1016/0002-8703(95)90034-9 [DOI:10.1016/0002-8703(95)90034-9]
24. Louvard Y, Krol M, Pezzano M, Sheers L, Piechaud JF, Marien C, et al. Feasibility of routine transradial coronary angiography: A single operator's experience. Journal of Invasive Cardiology. 11(9):543-8. PMID: 10745593 [PMID]
25. Saito S, Miyake S, Hosokawa G, Tanaka S, Kawamitsu K, Kaneda H, et al. Transradial coronary intervention in Japanese patients. Catheterization and Cardiovascular Interventions. 1999; 46(1):37–41. doi: 10.1002/(sici)1522-726x(199901)46:1<37::aid-ccd10>3.3.co;2-p https://doi.org/10.1002/(SICI)1522-726X(199901)46:1<37::AID-CCD10>3.3.CO;2-P [DOI:10.1002/(SICI)1522-726X(199901)46:13.3.CO;2-P]
26. Sakai H, Ikeda S, Harada T, Yonashiro S, Ozumi K, Ohe H, et al. Limitations of successive transradial approach in the same arm: The Japanese experience. Catheterization and Cardiovascular Interventions. 2001; 54(2):204–8. doi: 10.1002/ccd.1268 [DOI:10.1002/ccd.1268]
27. Saito S, Ikei H, Hosokawa G, Tanaka S. Influence of the ratio between radial artery inner diameter and sheath outer diameter on radial artery flow after transradial coronary intervention. Catheterization and Cardiovascular Interventions. 1999; 46(2):173–78. doi: 10.1002/(sici)1522-726x(199902)46:2<173::aid-ccd12>3.0.co;2-4 https://doi.org/10.1002/(SICI)1522-726X(199902)46:2<173::AID-CCD12>3.0.CO;2-4 [DOI:10.1002/(SICI)1522-726X(199902)46:23.0.CO;2-4]
28. Yokoyama N, Takeshita S, Ochiai M, Koyama Y, Hoshino S, Isshiki T, et al. Anatomic variations of the radial artery in patients undergoing transradial coronary intervention. Catheterization and Cardiovascular Interventions. 2000; 49(4):357–62. doi: 10.1002/(sici)1522-726x(200004)49:4<357::aid-ccd1>3.0.co;2-z https://doi.org/10.1002/(SICI)1522-726X(200004)49:4<357::AID-CCD1>3.0.CO;2-Z [DOI:10.1002/(SICI)1522-726X(200004)49:43.0.CO;2-Z]

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