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- W3207901825 abstract "Compared with transfemoral access (TFA), transradial access (TRA) for neurointerventional procedures is known to have superior safety, earlier ambulation, greater patient comfort, and possibly reduced cost with shorter hospital stay. The most compelling advantage is the lower rate of serious hemorrhagic access site complications, which is particularly relevant given the high rates of concurrent antithrombotic and/or thrombolytic medications used. TRA also has clear value over TFA where there is obesity, pregnancy, prior aortofemoral bypass or stents, and a type III aortic arch.1 Given the entrenched historical convention of using TFA, early advocates of TRA suggested a ‘radial first’ approach whereby a concentrated experience in TRA could more effectively yield sufficient proficiency. This messaging may have had unintended consequences of promoting the notion that TRA should be the default first option in all neurointerventional cases. The large volume of recent JNIS publications on this topic suggests otherwise: TRA should not be the default first choice. Instead, as these publications suggest, access decisions deserve a more thoughtful consideration of a variety of variables including the type of procedure being performed, the disease process being managed, and patient anatomy.Elective versus emergent, value of large catheters, and number of vessels that need catheterization are among several specific considerations when choosing access approach. Elective, single vessel neurointerventional cases seem well-suited for a TRA approach. A review of seven studies reported radial access procedural success for carotid artery stent placement with low rates of asymptomatic radial artery occlusion, forearm …" @default.
- W3207901825 created "2021-10-25" @default.
- W3207901825 creator A5066006180 @default.
- W3207901825 date "2021-10-15" @default.
- W3207901825 modified "2023-09-25" @default.
- W3207901825 title "Rethinking radial first" @default.
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- W3207901825 doi "https://doi.org/10.1136/neurintsurg-2021-018287" @default.
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