Transradial Access Results in Faster Skin Puncture to Reperfusion Time than Transfemoral Access in Posterior Circulation Mechanical Thrombectomy

Abstract

Background—Successful mechanical embolectomy for acute embolic arterial occlusion in the posterior
cerebral circulation can potentially result in less neurologic disability and mortality. The transradial
approach can potentially offer more direct navigation into the posterior circulation than the transfemoral
approach and can result in faster recanalization time.
Objective—To compare procedural metrics and the technical and clinical outcomes of transradial versus
transfemoral access for mechanical embolectomy in the posterior cerebral circulation.
Material and Methods—Single-center retrospective review of a prospectively maintained neurointerven‐
tional database from a large volume neurointerventional service in a tertiary academic center. Patients pre‐
senting with acute disabling symptoms due to embolic occlusion of a large intracranial artery in the poste‐
rior that underwent to endovascular treatment in our institution from January 2017 to January 2019 were
included in the present study.
Results—Between January 2018 and January 2019 a total of 10 subjects underwent a mechanical embo‐
lectomy for acute embolic occlusion on the posterior circulation via transradial access; and between Janu‐
ary 2017 and January 2018 a total of 10 subjects underwent a mechanical embolectomy for acute embolic
occlusion on the posterior circulation via transfemoral access. Subjects in the transradial access group had a
shorter skin puncture to recanalization time compared to the transfemoral group (29.2 ± 17.6 in the transra‐
dial group vs. 63.9 ± 56.7 in the transfemoral group respectively).
Conclusions—This is the first study comparing transradial versus transfemoral access for mechanical
embolectomy in patients with acute embolic occlusion in the posterior cerebral circulation. Transradial
access resulted in a safe, effective, and faster endovascular route for recanalization in the acute embolic
occlusion of the posterior circulation