Safety and efficacy of using a large bore guide catheter through a short 8-Fr sheath for transradial neurointerventional procedures

IntroductionDespite broader acceptance of transradial approach (TRA) for neurointerventional procedures, there is a paucity of data describing the technique and safety of using a short 8-Fr sheath with large bore 8-French guide catheters in the radial artery. The purpose of this study is to describe the technique and evaluate the safety and feasibility of a short 8-Fr sheath in the radial artery for neurointerventional procedures.MethodsConsecutive patients who had neurointerventional procedures with TRA using a short 8-Fr sheath between January 2019 and March 2024 were identified retrospectively utilizing our prospectively maintained institutional database. Procedures were evaluated for technical success, radial artery avulsion or extravasation, and the rate of radial artery patency among patients who had a follow-up procedure.ResultsTRA with a short 8-Fr sheath was attempted in 94 consecutive patients (52.1% women; median age 68 years) for a total of 111 procedures. TRA procedures were successfully completed in 82.0% (<i>n</i> = 100) of the cases. 20 procedures (18.0%) required crossover to TFA. In 28 patients who underwent radial artery ultrasound at follow-up angiography (median follow-up time 8.1 months), 23 patients (82.1%) had a patent radial artery, while 17.9% (<i>n</i> = 5) had partial thrombosis of the radial artery, which was recanalized by the access wire.ConclusionUsing a short 8-Fr sheath during TRA for neurointerventional procedures with large bore 8-Fr guide catheters is safe and feasible, with a high procedural success and favorable safety profile.