Journal article
A comparative study of transradial versus transfemoral approach for flow diversion
Neuroradiology, Vol.63(8), pp.1335-1343
08/01/2021
DOI: 10.1007/s00234-021-02672-4
PMID: 33560470
Abstract
Purpose Data in neurointerventional literature is extremely limited regarding the safety and efficacy of flow diversion using transradial access (TRA). We aim to demonstrate the safety and efficacy of intracranial aneurysm treatment with the Pipeline Embolization Device (PED) using TRA compared to transfemoral access (TFA). Methods We conducted a retrospective analysis of a prospectively maintained database and identified 79 consecutive patients who underwent neuroendovascular embolization for cerebral aneurysms using the PED from April 2018 through October 2019. Patients were divided into 2 groups: TRA (32 patients) and TFA (47 patients). A comparative analysis was performed between the two groups. Results There was no significant difference in postoperative intracranial hemorrhage (p>.99), symptomatic ischemic stroke (p=.512), access site complications (p=.268), or other complications (p=.512). However, there was a significant increase in overall complications (14.9% vs. 0.0%, p=.038) and procedure duration (71.4 min +/- 31.2 vs. 58.5 +/- 20.3, p=.018) in the TFA group. There was no significant difference in complete occlusion at latest follow-up (19/25, 76.0% vs. 35/40, 87.5%; p=.311), 6-month follow-up (17/23, 73.9% vs. 33/38, 86.8%; p=.303), or 12-month follow-up (8/8, 100.0% vs. 5/6, 83.3%; p=.429). There was also no significant difference in rate of retreatment (p>.99), morbidity (p=.512), mortality (p>.99), latest follow-up (p=.985), or loss of follow-up (p=.298). Conclusions The feasibility and efficacy of flow diversion with the PED via TRA for the treatment of intracranial aneurysms is comparable to TFA. Widespread adoption of this approach may be facilitated by improvements in device navigation and manipulation via radial-specific engineering.
Details
- Title: Subtitle
- A comparative study of transradial versus transfemoral approach for flow diversion
- Creators
- Joshua H. Weinberg - Thomas Jefferson University HospitalAhmad Sweid - Thomas Jefferson University HospitalBatoul Hammoud - Children's Hospital of PhiladelphiaAshlee Asada - Drexel UniversityCannon Greco-Hiranaka - Thomas Jefferson UniversityKeenan Piper - Thomas Jefferson UniversityMichael Reid Gooch - Thomas Jefferson University HospitalStavropoula Tjoumakaris - Thomas Jefferson University HospitalNabeel Herial - Thomas Jefferson University HospitalDavid Hasan - University of Iowa Hospitals and ClinicsHekmat Zarzour - Thomas Jefferson University HospitalRobert H. Rosenwasser - Thomas Jefferson University HospitalPascal Jabbour - Thomas Jefferson University Hospital
- Resource Type
- Journal article
- Publication Details
- Neuroradiology, Vol.63(8), pp.1335-1343
- Publisher
- Springer Nature
- DOI
- 10.1007/s00234-021-02672-4
- PMID
- 33560470
- ISSN
- 0028-3940
- eISSN
- 1432-1920
- Number of pages
- 9
- Language
- English
- Date published
- 08/01/2021
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering
- Record Identifier
- 9984419247902771
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