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A comparative study of transradial versus transfemoral approach for flow diversion.
Weinberg, Joshua H; Sweid, Ahmad; Hammoud, Batoul; Asada, Ashlee; Greco-Hiranaka, Cannon; Piper, Keenan; Gooch, Michael Reid; Tjoumakaris, Stavropoula; Herial, Nabeel; Hasan, David; Zarzour, Hekmat; Rosenwasser, Robert H; Jabbour, Pascal.
Afiliación
  • Weinberg JH; Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
  • Sweid A; Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
  • Hammoud B; Department of Pediatric Endocrinology, Children Hospital of Philadelphia, Philadelphia, PA, USA.
  • Asada A; Drexel University College of Medicine, Drexel University, Philadelphia, PA, USA.
  • Greco-Hiranaka C; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.
  • Piper K; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.
  • Gooch MR; Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
  • Tjoumakaris S; Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
  • Herial N; Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
  • Hasan D; Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
  • Zarzour H; Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
  • Rosenwasser RH; Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
  • Jabbour P; Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA. pascal.jabbour@jefferson.edu.
Neuroradiology ; 63(8): 1335-1343, 2021 Aug.
Article en En | MEDLINE | ID: mdl-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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Aneurisma Intracraneal / Embolización Terapéutica Tipo de estudio: Observational_studies Límite: Humans Idioma: En Revista: Neuroradiology Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Aneurisma Intracraneal / Embolización Terapéutica Tipo de estudio: Observational_studies Límite: Humans Idioma: En Revista: Neuroradiology Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos
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