Transition to radial approach for neurovascular procedures is safe and convenient: Characterization of a learning experience

David Vergara-Garcia, Santiago Gomez-Paz, Timothy M. Robinson, Justin Moore, Christopher S. Ogilvy, Ajith J. Thomas

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: The transradial access for endovascular procedures has become a popular access point of preference for both patients and for many neuro-endovascular practitioners. OBJECTIVE: To describe a single-center experience on the transition to a radial-first approach for neurovascular procedures, focused on diagnostic angiographies, and to compare the differences in terms of length of procedure within the first 5 mo of its execution. METHODS: We performed a retrospective review of a prospective maintained cerebrovascular registry at an academic institution within the United States, to identify the expected adoption curve required to transition to a transradial route first approach focused mainly on diagnostic procedures. The 5 mo of experience were divided into 4 quartiles evenly distributed in time. The primary outcome was the total length of procedure. Secondary outcomes were access failure, radiation dose, the usefulness of ultrasound assistance and complications. RESULTS: A total of 121 transradial procedures were performed: 113 diagnostic angiographies (93%) and 8 therapeutic interventions (7%). We identified 6 access failures (5%) and 1 complication (1%). The mean length for diagnostic angiographies was 24 ± 10 min, and for therapeutic procedures was 58 ± 19 min. A multivariate regression analysis demonstrated a significant decrease in the total length of procedures after the first quartile. CONCLUSION: The transradial route shows to be a safe and convenient approach. The total length of procedure starts decreasing as providers gain experience and become more confident with this route, as seen in our 5-mo experience.

Original languageEnglish (US)
Pages (from-to)489-494
Number of pages6
JournalOperative Neurosurgery
Volume19
Issue number5
DOIs
StatePublished - Nov 1 2020

Keywords

  • Cerebrovascular
  • Diagnostic angiography
  • Endovascular
  • Learning curve
  • Neurosurgery
  • Radial access
  • Radial artery
  • Radiation dose
  • Transradial

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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