A comparison of radial versus femoral artery access for acute stroke interventions

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  • Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
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OBJECTIVE

In this study, the authors aimed to investigate procedural and clinical outcomes between radial and femoral artery access in patients undergoing thrombectomy for acute stroke.

METHODS

The authors conducted a single-institution retrospective analysis of 104 patients who underwent mechanical thrombectomy, 52 via transradial access and 52 via traditional transfemoral access. They analyzed various procedural and clinical metrics between the two patient cohorts.

RESULTS

There was no difference between patient demographics or presenting symptoms of stroke severity between patients treated via transradial or transfemoral access. The mean procedural time was similar between the two treatment cohorts: 60.35 ± 36.81 minutes for the transradial group versus 65.50 ± 29.92 minutes for the transfemoral group (p = 0.451). The mean total fluoroscopy time for the procedure was similar between the two patient cohorts (20.31 ± 11.68 for radial vs 18.49 ± 11.78 minutes for femoral, p = 0.898). The majority of patients underwent thrombolysis in cerebral infarction score 2b/3 revascularization, regardless of access site (92.3% for radial vs 94.2% for femoral, p = 0.696). There was no significant difference in the incidence of access site or periprocedural complications between the transradial and transfemoral cohorts.

CONCLUSIONS

Acute stroke intervention performed via transradial access is feasible and effective, with no significant difference in procedural and clinical outcomes compared with traditional transfemoral access. Larger studies are required to further validate the efficacy and limitations of transradial access for neurointerventional procedures.

ABBREVIATIONS ICA = internal carotid artery; NIHSS = National Institutes of Health Stroke Scale; TICI = thrombolysis in cerebral infarction; tPA = tissue plasminogen activator.

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Contributor Notes

Correspondence Pascal M. Jabbour: Thomas Jefferson University Hospital, Philadelphia, PA. pascal.jabbour@jefferson.edu.

INCLUDE WHEN CITING Published online November 13, 2020; DOI: 10.3171/2020.7.JNS201174.

Disclosures The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

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