Transradial intra-aortic catheter looping in the angioplasty of severe intracranial symptomatic arteriosclerotic diseases

Frontiers in Neurology

Neurology

Tian-Xiao Li¹  Dong-Yang Cai¹  Bo-Wen Yang¹  Bu-Lang Gao¹  Zi-Liang Wang¹  Jiang-Yu Xue¹  Jin-Chao Xia¹  Tong-Yuan Zhao¹  Gang-Qin Xu¹ 

[1] Cerebrovascular Disease Hospital of Henan Provincial People's Hospital, Zhengzhou, Henan, China;Endovascular Intervention Center, Zhengzhou University People's Hospital, Zhengzhou, Henan, China;Henan Provincial International Joint Laboratory of Cerebrovascular Diseases, Zhengzhou, Henan, China;

关键词: transradial access;    intra-aortic guiding catheter looping;    atherosclerotic stenosis;    occlusion;    large intracranial arteries;    angioplasty;   

DOI  :  10.3389/fneur.2023.1226306

 received in 2023-05-21, accepted in 2023-09-13,  发布年份 2023

来源: Frontiers

【 摘 要 】

PurposeThis study aims to investigate the effect and feasibility of intra-aortic catheter looping via transradial access in angioplasty for symptomatic intracranial severe (>70%) atherosclerotic stenosis or occlusion of large arteries (SISOLAs).Materials and methodsPatients with SISOLAs who underwent transradial endovascular angioplasty using the catheter looping technique in the ascending aorta were retrospectively enrolled. The clinical data and treatment outcomes were analyzed.ResultsFifteen patients aged 48–71 years were enrolled in this study. Left vertebrobasilar artery occlusion was present in 1 (6.7%) patient, severe left middle cerebral artery stenosis in 7 (46.7%) patients, severe left internal carotid artery (ICA) stenosis of the ophthalmic segment in 4 (26.7%) patients, severe left ICA stenosis of the cavernous segment in 2 (13.3%) patients, and severe right middle cerebral artery stenosis in 2 (13.3%) patients. The arterial stenosis ranged from 70 to 92% (mean 86%) before stenting. The looping of a guiding catheter in the ascending aorta via transradial access for angioplasty was successful in all patients (100%). The vertebral artery intracranial segment occlusion was successfully recanalized, while severe stenosis in the remaining 14 patients was successfully eliminated. After endovascular recanalization, the residual stenosis was reduced by 12–26% (median 18%). No puncture-related complications or surgical-related neurological complications occurred in these patients. In the follow-up angiography conducted on 10 (66.7%) patients after 6–25 months, no in-stent restenosis was detected.ConclusionIntra-aortic guiding catheter looping via transradial access for endovascular angioplasty of SISOLAs is technically safe, feasible, and effective, especially when the transfemoral artery approach is difficult or impossible to undertake.

【 授权许可】

Unknown   
Copyright © 2023 Xu, Xia, Cai, Yang, Zhao, Xue, Wang, Li and Gao.