Distal transradial access in the anatomical snuffbox for balloon guide-assisted stentriever mechanical thrombectomy: Technical note and case report

Gary B Rajah; Bryan Lieber; Ari D Kappel; Ali W Luqman

doi:10.4103/bc.bc_22_19

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CASE REPORT

Year : 2020 | Volume : 6 | Issue : 1 | Page : 60-64

Distal transradial access in the anatomical snuffbox for balloon guide-assisted stentriever mechanical thrombectomy: Technical note and case report

Gary B Rajah¹, Bryan Lieber², Ari D Kappel², Ali W Luqman³
¹ Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo; Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, NY, USA
² Department of Neurosurgery and Neurology, Wayne State University, Detroit, MI, USA
³ Department of Neurosurgery and Neurology, Wayne State University; Department of Neurosurgery, Detroit Medical Center, Detroit, MI, USA

Correspondence Address:
Dr. Ari D Kappel
Department of Neurosurgery, Detroit Medical Center, Harper Professional Building, 4160 John R St., Suite #925, Detroit, MI 48201
USA

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/bc.bc_22_19

Recent trends in neuroendovascular surgery have seen a rise in alternative access utilization. Social media feeds such as #RadialFirst or #RadialForNeuro are the beacons of a growing movement among more and more endovascular neurosurgeons, as they venture away from the traditional femoral access gravitating toward radial access. We have previously shown our distal radial access technique utilizing the snuffbox to be a reliable means of endovascular access and in addition to traditional ventral radial access provides access to the entire cerebrum. Stroke thrombectomy often encounters reticence from those who prefer transfemoral access over the radial access. Thrombectomy has been performed radially in a few series and only once previously in a case report of distal radial access for thrombectomy. Hesitance to adopt radial access for mechanical thrombectomy is often related to perceived increased access times and a lack of suitable balloon guide catheters for radial techniques. Here, we present one of the first descriptions of a distal transradial access with balloon guide flow arrest for stentriever thrombectomy.

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