Pearls and Pitfalls: Radial First for Neurointervention


The first description of transradial access (TRA) was published in 1989 by Campeau from the Montreal Heart Institute.1 Since then, the American Heart Association (AHA) has recommended a radial-first strategy for coronary interventions due to level 1 evidence demonstrating a > 60% reduction in access site complications and significant decreases in all-cause mortality with TRA.2-4 Progressive adoption of TRA for coronary, peripheral, and neurointerventional procedures has been further driven by additional TRA advantages, including immediate ambulation, reduced postprocedural hospital stay and cost, and overwhelming patient preference.5,6 However, underuse of TRA in the neurointerventional community remains due to challenges with the initial learning curve and dedicated radial neurointervention tools, as well as a lack of training. This article provides a guide for successful transradial neurointervention from setup to closure, including strategies to avoid pitfalls and overcome challenges.

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Chen SH, et al. Endovascular Today 2019;18;11:42-46.