First case series of the transradial approach for neurointerventional procedures in pediatric patients

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  • 1 Departments of Neurological Surgery and
  • 2 Neurology, Rutgers New Jersey Medical School, Newark, New Jersey
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OBJECTIVE

The transradial approach (TRA) has been widely adopted by interventional cardiologists but is only now being accepted by neurointerventionalists. The benefits of the TRA over the traditional transfemoral approach (TFA) include reduced risk of adverse clinical events and faster recovery. The authors assessed the safety and feasibility of the TRA for neurointerventional cases in the pediatric population.

METHODS

Pediatric patients undergoing cerebrovascular interventions since implementation of the TRA at the authors’ institution were retrospectively reviewed. Pertinent patient information, procedure indications, vessels catheterized, fluoroscopy time, and complications were reviewed.

RESULTS

There were 4 patients in this case series, and their ages ranged from 13 to 15 years. Each patient tolerated the procedure performed using the TRA without any postprocedural issues, and only 1 patient experienced radial artery spasm, which resolved with the administration of intraarterial verapamil. None of the patients required conversion to the TFA.

CONCLUSIONS

The TRA can be considered a safe alternative to the TFA for neurointerventional procedures in the pediatric population and provides potential advantages. However, as pediatric patients require special consideration due to their smaller-caliber arteries, routine use of ultrasound guidance is advised when attempting the TRA.

ABBREVIATIONS TFA = transfemoral approach; TRA = transradial approach.

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Contributor Notes

Correspondence Priyank Khandelwal: Rutgers New Jersey Medical School, Newark, NJ. pk544@njms.rutgers.edu.

INCLUDE WHEN CITING Published online January 31, 2020; DOI: 10.3171/2019.12.PEDS19448.

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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