Transradial Access for Neurointervention: a Case Series from a Tertiary Centre in Hong Kong

Introduction: Despite several retrospective studies showing the safety and efficacy of transradial access (TRA) for a variety of neurointerventions, the evidence in Asian populations is limited. The smaller size of the radial artery in Asians could cause technical difficulty in access as well as access site complications. This study aimed to assess the feasibility and safety of TRA for neurointervention in an Asian population. Methods: We performed a retrospective review of neurointerventions performed with TRA in our hospital between January 2018 and June 2021. Technical success was defined as TRA with insertion of the sheath and completion of the intervention without crossover to conventional transfemoral access (TFA). The primary endpoint was the in-hospital stay plus the 30-day incidence of access site haematoma requiring surgical treatment or transfusion, symptomatic radial artery occlusion, hand ischaemia, arteriovenous fistula, pseudoaneurysm, and wound infection. The secondary endpoints were procedure-related complications including intra-operative vessel injury, cerebral thromboembolism, and haemorrhagic complications. Results: A total of 45 patients underwent neurointerventions (transcatheter embolisation of aneurysms/arteriovenous malformations/tumours, and extracranial carotid stenting) via TRA. The technical success rate was 93.3%. There were no significant access site complications. The overall procedure-related complication rate was 11.1%. Conclusion: In an Asian population, neurointervention via TRA is feasible, with a low crossover rate and low incidence of access site complications. In this case series, there was no increase in the procedure-related complication rate when compared with TFA.