Efficacy and safety of 6Fr R2P destination slender for transradial neuroendovascular procedures: Single institution retrospective series of 97 patients

BackgroundThe transradial approach (TRA) has recently gained significant interest in the neuro-interventional community. A 6 French (6Fr) guide sheath system is the gold standard for most neuro-interventions. Most 6Fr devices available in the market are developed for transfemoral access and thus lack the torqueability necessary for TRAs. This study aimed to evaluate the safety and feasibility of the 6Fr Terumo R2P Destination Slender Guiding Sheath (TDGS) for neuro-interventional procedures.MethodsA retrospective review of consecutive patients who underwent TRA neuro-interventions using a 6Fr Terumo R2P Destination Slender Guiding Sheath between June 2021 and November 2023 was conducted. Clinical, radiographic, procedural data, complications, and immediate outcomes were reviewed.ResultsNinety-seven patients were identified. The 6Fr TDGS was able to navigate into the carotid system for the interventional procedure via TRA in 90 cases (92.78%). Two cases were initiated via TRA but were aborted due to vessel tortuosity (2.06%), and five cases were pre-operatively converted to a transfemoral approach due to operator preference (5.15%). Pre-procedure radial artery diameter ranged from 1.6 to 4.1 mm. The immediate post-procedure radial artery occlusion rate was 0%. No immediate or delayed access site complications were identified.ConclusionThe 6Fr TDGS is safe and efficacious for TRA neuro-intervention procedures. It provided adequate support, torqueability, and kink resistance for the majority of cases. These results may change clinical practice and demonstrate the need for larger studies regarding the safety and efficacy of the 6Fr TDGS.