Comparison of transradial and transfemoral access for the Woven EndoBridge embolization of intracranial aneurysms: A single-center experience

Background Transradial access has been adopted more commonly in the neuroendovascular field. However, the experience of using this access for the Woven EndoBridge embolization of intracranial aneurysms is still in the early stage. Objective This study aimed to compare the outcomes between transradial access and transfemoral access for the Woven EndoBridge embolization of intracranial aneurysms. Methods This is a retrospective analysis of consecutive intracranial aneurysms treated with Woven EndoBridge placement between May 2019 and August 2020 by the senior author at a high-volume center. The aneurysms of all sizes and locations treated with Woven EndoBridge placement with or without adjunctive stent or coiling were included. Patient demographics, aneurysm and treatment characteristics, procedural complications, and angiographic and functional outcomes were compared between two approaches. Results This study included a total of 34 patients with intracranial aneurysms (median age 60 years, female-to-male ratio 2:1). Of these, the radial access was utilized in 20 (58.8%) patients, while the femoral access was used in 14 (41.2%) patients. A Woven EndoBridge device was successfully deployed in all cases, and none of the patients required a crossover to another access. There were no significant differences in baseline characteristics, procedure time and fluoroscopy time, outcomes, and complication rates between both groups. Conclusion Our report suggests the possible feasibility and safety of the transradial access for the Woven EndoBridge embolization of intracranial aneurysms. However, the results of this study are suggestive rather than conclusive, and there is still a need for future large prospective studies.

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Treatment of Wide-Neck Intracranial Aneurysms with the Woven EndoBridge Device Associated with Stenting: A Single-Center Experience

American Journal of Neuroradiology ◽

10.3174/ajnr.a6032 ◽

2019 ◽

Vol 40 (5) ◽

pp. 820-826 ◽

Cited By ~ 7

Author(s):

F. Cagnazzo ◽

R. Ahmed ◽

C. Dargazanli ◽

P.-H. Lefevre ◽

G. Gascou ◽

...

Keyword(s):

Intracranial Aneurysms ◽

Single Center ◽

Single Center Experience ◽

Woven Endobridge ◽

Wide Neck

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Single center experience and technical nuances in the treatment of distal anterior cerebral artery aneurysms

Romanian Neurosurgery ◽

10.1515/romneu-2017-0003 ◽

2017 ◽

Vol 31 (1) ◽

pp. 17-24 ◽

Cited By ~ 1

Author(s):

Dorin Nicolae Gherasim ◽

Gabriel Gyorki ◽

Adrian Balasa

Keyword(s):

Cerebral Artery ◽

Intracranial Aneurysms ◽

Anterior Cerebral Artery ◽

Complication Rates ◽

Ruptured Aneurysms ◽

Single Center Experience ◽

Radiological Data ◽

Treatment Morbidity ◽

Distal Anterior Cerebral Artery ◽

Lost To Follow Up

AbstractObjective: This study presents the experience of one neurosurgical center in the treatment of 18 consecutive patients with distal anterior cerebral artery (DACA) aneurysms during a 10 years period. Our aim was to compare treatment outcomes of these lesions with intracranial aneurysms in general, and to present technical nuances in surgical treatment.Methods: We analyzed the clinical and radiological data of 18 patients treated between 2005 and 2015. All patients were treated surgically using the microscope. No patients were lost to follow-up. We compared treatment and outcome of ruptured DACA aneurysms (n 18) with all consecutive ruptured aneurysms treated in our clinic during the same period (n 446).Results: DACA aneurysms accounted for 4% of all intracranial aneurysms. They were smaller (median, 5,5 versus 9 mm) We found only one case with associated aneurysms (5,5%). DACA aneurysms presented more often with intracerebral hematomas (39% versus 26%) than ruptured aneurysms in general. Their microsurgical treatment showed the same complication rates (treatment morbidity, 15%) as for other ruptured aneurysms in literature. Their mortality rate was lower (11% versus 24%).Conclusion: Despite their specific anatomic features, and particular surgical technique, with modern treatment methods, ruptured DACA aneurysms have the same favorable outcome and lower mortality as ruptured aneurysms in general.

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Endovascular treatment of intracranial aneurysms using the Woven EndoBridge (WEB) device: retrospective analysis of a single center experience

Clinical Imaging ◽

10.1016/j.clinimag.2019.09.001 ◽

2020 ◽

Vol 59 (1) ◽

pp. 25-29 ◽

Cited By ~ 3

Author(s):

Hasan E. Kaya ◽

Süleyman Bakdık ◽

Fatih Keskin ◽

Mehmet F. Erdi ◽

Osman Koç

Keyword(s):

Endovascular Treatment ◽

Retrospective Analysis ◽

Intracranial Aneurysms ◽

Single Center ◽

Single Center Experience ◽

Woven Endobridge ◽

Web Device

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Efficiency and complications of Woven EndoBridge (WEB) devices for treatment of larger, complex intracranial aneurysms—a single-center experience

Acta Neurochirurgica ◽

10.1007/s00701-018-3752-0 ◽

2018 ◽

Vol 161 (2) ◽

pp. 393-401 ◽

Cited By ~ 4

Author(s):

Zaid Khalid ◽

Wilhelm Sorteberg ◽

Bård Nedregaard ◽

Angelika Sorteberg

Keyword(s):

Intracranial Aneurysms ◽

Single Center ◽

Single Center Experience ◽

Woven Endobridge

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Effectiveness of Robotic Lobectomy—Outcome and Learning Curve in a High Volume Center

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0038-1639477 ◽

2018 ◽

Vol 67 (07) ◽

pp. 573-577 ◽

Cited By ~ 5

Author(s):

Danjouma Housmanou Cheufou ◽

Khaled Mardanzai ◽

Till Ploenes ◽

Dirk Theegarten ◽

Georgios Stamatis ◽

...

Keyword(s):

Robotic Surgery ◽

Thoracic Surgery ◽

Learning Curve ◽

Operative Time ◽

Thoracoscopic Surgery ◽

High Volume ◽

Tumor Stage ◽

Minimal Invasive ◽

Complication Rates ◽

Single Center Experience

Background Robotic surgery has been developed as a sophisticated tool to expand possibilities in minimal invasive surgery. The learning curve for this method is short in various surgical fields; however, limited data exist on the learning curve in robotic thoracic surgery. Methods This study analyzes a single center experience of robotic lobectomies using a prospectively kept database. Perioperative data and outcome of patients during the learning curve were compared with patients operated with increased institutional experience. The learning curve was defined as the initial 20 lobectomies. Results Sixty-four robotic lobectomies were performed between January 2014 and February 2017. Indications, preoperative lung functions, comorbidities, patient age, and tumor stage were comparable between patients operated during the learning curve and thereafter. The mean operative time could be significantly reduced after the learning curve (286 ± 86 vs. 211 ± 62 minutes; p = 0.0003). The conversion rate dropped from 4 of 20 (20%) during the learning curve to 2 of 44 (4.5%, p = 0.07) thereafter. Chest tube duration (4.3 ± 2.9 vs. 3.8 ± 2.1 days) and hospital stay (8.3 ± 3.4 vs. 7.9 ± 4.5 days) were not different in the two phases. The number of resected lymph nodes increased from 11.2 ± 6.8 to 13.9 ± 6.5 (p = 0.0797). Lymph node upstaging was achieved in 8 (12.9%) cases. Ninety-day mortality was 0%, and 2-year overall survival was 83%. Conclusions Robotic thoracic surgery can be safely performed and trained with low complication rates and contributes to the extension of minimal invasive thoracic surgery. The initial learning curve in our experience is overcome after 20 cases. However, to become proficient in more advanced procedures and to further reduce operative time, additional training is required. Prospective studies are required to clearly determine the role of robotic surgery in comparison to the video-assisted thoracoscopic surgery (VATS) procedures.

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Endovascular treatment of medium and large intracranial aneurysms with large volume coils: A single-center experience

Surgical Neurology International ◽

10.25259/sni_947_2021 ◽

2022 ◽

Vol 13 ◽

pp. 9

Author(s):

Giancarlo Saal-Zapata ◽

Basavaraj Ghodke ◽

Melanie Walker ◽

Ivethe Pregúntegui-Loayza ◽

Rodolfo Rodríguez-Varela

Keyword(s):

Endovascular Treatment ◽

Clinical Outcomes ◽

Large Volume ◽

Intracranial Aneurysms ◽

Intraoperative Complications ◽

Complication Rates ◽

Single Center ◽

Single Center Experience ◽

The Mean

Background: Large volume coils are an alternative to conventional coils for the treatment of intracranial aneurysms. However, there are no published reports documenting occlusion and complication rates in medium and large intracranial aneurysms. Therefore, we present our results in this subgroup of aneurysms. Methods: A single-center, retrospective analysis of consecutive patients treated with Penumbra coils 400 in aneurysms ≥7 mm was performed. Demographics, aneurysm features, procedural details, intraoperative complications, clinical outcomes, and occlusion rates were analyzed. Results: Thirty-three patients were included for analysis, and a total of 33 intracranial aneurysms were analyzed. Mean age was 57.6 years (SD ± 12.4) and 85% of the patients were women. Large aneurysms represented 46% of cases. Paraclinoid (55%) followed by posterior communicating (30.3%) aneurysms was the most frequently treated. Ruptured and saccular aneurysms were found in 49% and 63% of the cases, respectively. The mean aneurysmal dimensions were 14.2 mm width, 11.9 mm length, 5.4 mm neck, and 2.4 dome-to-neck ratio. A dome-neck ratio <2 was identified in 39% of cases. The mean number of coils per aneurysm was 4.8. Immediate modified Raymond–Roy Grades 1, 2, and 3A were achieved in 15%, 21%, and 64%, respectively. Twenty-six patients were evaluated at a mean follow-up period of 11 months, with an adequate occlusion of 92% and a good clinical outcome (modified Rankin score ≤2) in 96% of patients. Conclusion: Endovascular treatment with PC400 coils is an effective and safe option for medium and large intracranial aneurysms with high occlusion rates, few complications, and good clinical outcomes at follow-up.

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Incorporation of transradial approach in neuroendovascular procedures: defining benchmarks for rates of complications and conversion to femoral access

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2020-015893 ◽

2020 ◽

Vol 12 (11) ◽

pp. 1122-1126 ◽

Cited By ~ 5

Author(s):

Eyad Almallouhi ◽

Sami Al Kasab ◽

Mithun G Sattur ◽

Jonathan Lena ◽

Pascal M Jabbour ◽

...

Keyword(s):

Interventional Procedures ◽

Early Stage ◽

Diagnostic Procedures ◽

Complication Rates ◽

Access Site ◽

Femoral Access ◽

Transradial Approach ◽

Wide Range ◽

The Usa ◽

Baseline Characteristics

BackgroundThe transradial approach (TRA) has gained increasing popularity for neuroendovascular procedures. However, the experience with TRA in neuroangiography is still in early stages in most centers, and the safety and feasibility of this approach have not been well established. The purpose of this study is to report the safety and feasibility of TRA for neuroendovascular procedures.MethodsWe reviewed charts from six institutions in the USA to include consecutive patients who underwent diagnostic or interventional neuroendovascular procedures through TRA from July 2018 to July 2019. Collected data included baseline characteristics, procedural variables, complications, and whether there was a crossover to transfemoral access.ResultsA total of 2203 patients were included in the study (age 56.1±15.2, 60.8% women). Of these, 1697 (77%) patients underwent diagnostic procedures and 506 (23%) underwent interventional procedures. Successfully completed procedures included aneurysm coiling (n=97), flow diversion (n=89), stent-assisted coiling (n=57), balloon-assisted coiling (n=19), and stroke thrombectomy (n=76). Crossover to femoral access was required in 114 (5.2%). There were no major complications related to the radial access site. Minor complications related to access site were seen in 14 (0.6%) patients.ConclusionIn this early stage of transforming to the ‘radial-first’ approach for neuroendovascular procedures, TRA was safe with low complication rates for both diagnostic and interventional procedures. A wide range of procedures were completed successfully using TRA.

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Transradial Access: A Comprehensive Review

Vascular and Endovascular Review ◽

10.15420/ver.2020.17 ◽

2021 ◽

Vol 4 ◽

Author(s):

Shawn Hobby ◽

Maxwell Stroebel ◽

Ricardo Yamada ◽

Thor Johnson ◽

Andre Uflacker ◽

...

Keyword(s):

Radial Artery ◽

Lower Cost ◽

Artery Occlusion ◽

Patient Comfort ◽

Complication Rates ◽

Femoral Access ◽

Transradial Access ◽

Lower Complication ◽

Anatomic Variants ◽

Left Radial Artery

Transradial access (TRA) via the left radial artery is an alternative to traditional transfemoral access for catheter-based procedures that is becoming increasingly more relevant in all types of arterial vascular interventions. First investigated in the realm of cardiology, TRA has been proven to provide many benefits (such as lower complication rates, lower cost, and improved patient comfort during and after the procedure) when compared with traditional femoral access while maintaining efficacy. This article provides an in-depth summary of the technical aspects of radial access while incorporating more recent data to explain patient preference for TRA, and the ways that TRA can improve peri-procedure workflow and compensation. It also describes potential complications, such as radial artery spasm, difficult anatomic variants and radial artery occlusion, and then gives techniques for mitigating and treating these complications. The article explains why TRA has become an important option for vascular and interventional radiology physicians, and why it is likely that this will continue to grow in relevance.

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Abstract 64: Transradial Approach: The Future of Neurointervention-A Muticenter Collaboration

Stroke ◽

10.1161/str.51.suppl_1.64 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Eyad Almallouhi ◽

Sami Al Kasab ◽

Robert Starke ◽

Jonathan R Lena ◽

Ahmad Sweid ◽

...

Keyword(s):

Interventional Procedures ◽

Early Stage ◽

Major Complication ◽

High Volume ◽

The United States ◽

Access Site ◽

Femoral Access ◽

Transradial Approach ◽

Wide Range ◽

Forearm Pain

Introduction: Transradial approach (TRA) has gained significant popularity in the neuroendovascular world over the past few years. The purpose of this study is to report early experience in TRA from high volume centers. Methods: We reviewed charts from 4 institutions in the United States to include consecutive patients who underwent diagnostic or interventional neuroendovascular procedure through TRA from July 2018 to July 2019. Collected data included baseline characteristics, procedural variables, whether there was crossover to transfemoral access and complications. Results: A total of 1272 patients were included in the series (age 57.2 ± 15.3, 46.3% females). Out of those, 1054 (82.9%) patients underwent diagnostic cerebral angiograms and 218 (17.1%) underwent interventional procedures. Successfully completed procedures included aneurysm primary coiling (62 patients), stent assisted coiling (44 patients), flow diversion (40 patients), balloon assisted coiling (21 patients), and stroke thrombectomy (24 patients). The large vessels were selected as following: right vertebral artery (VA) in 74.2% of the cases, right internal carotid artery (ICA) in 75.4% of the cases, left VA in 51.4% of the cases, left ICA in 69.1% of the cases. Crossover to femoral access was required in 82 (6.4%) patients (most common cause was inability to reach the target vessel in 13 patients). None of the included patients had major complication related to the access site. Minor complications related to access site were seen in 30 (2.4%) patients. Of those, 11 patients had forearm hematoma, 8 had mild-moderate vasospasm, 6 had forearm pain, and 5 had oozing from the access site. Conclusion: In this early stage of transforming to radial-first approach for neurointerventions, TRA was reasonably safe with relatively low complication rate for both diagnostic and interventional procedures. Wide range of procedures were completed successfully using TRA.

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