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Transradial Approach for Deployment of a Flow Diverter for an Intracranial Aneurysm in a Patient with a Type-3 Aortic Arch.
Journal of Vascular and Interventional Neurology 2017 October
Background: Flow diversion with the Pipeline embolization device (PED) is an effective treatment for giant and wide-neck intracranial aneurysms, but the standard transfemoral approach may not be feasible in patients with Type-3 aortic arches.
Case Report: An 84-year-old woman presented with a right internal carotid artery (ICA) giant aneurysm and a Type-3 aortic arch, necessitating a transradial approach for access to the right common carotid artery. A triaxial catheter system made for a stable platform for the deployment of two telescoping PEDs to treat the patient's right ICA giant aneurysm. The procedure was technically successful, and there were no immediate complications.
Conclusion: The transradial approach allows for carotid access in patients with challenging aortic arches, and this report demonstrates its effectiveness for deployment of flow diverters, especially with a triaxial catheter system. The peripheral access point facilitates hemostasis, which is of great importance in patients on antiplatelet medications to prevent thrombotic complications of flow diverters.
Case Report: An 84-year-old woman presented with a right internal carotid artery (ICA) giant aneurysm and a Type-3 aortic arch, necessitating a transradial approach for access to the right common carotid artery. A triaxial catheter system made for a stable platform for the deployment of two telescoping PEDs to treat the patient's right ICA giant aneurysm. The procedure was technically successful, and there were no immediate complications.
Conclusion: The transradial approach allows for carotid access in patients with challenging aortic arches, and this report demonstrates its effectiveness for deployment of flow diverters, especially with a triaxial catheter system. The peripheral access point facilitates hemostasis, which is of great importance in patients on antiplatelet medications to prevent thrombotic complications of flow diverters.
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