Transradial versus transfemoral access for anterior circulation mechanical thrombectomy: analysis of 375 consecutive cases  

作　　者：Timothy John Phillips Matthew Thomas Crockett Gregory D Selkirk Ruchi Kabra Albert Ho Yuen Chiu Tejinder Singh Constantine Phatouros William McAuliffe 

机构地区：[1]Neurological Intervention and Imaging Service of Western Australia,Sir Charles Gairdner Hospital,Perth,Western Australia,Australia [2]Neurological Intervention and Imaging Service of Western Australia,Fiona Stanley Hospital,Perth,Western Australia,Australia [3]Neurological Intervention and Imaging Service of Western Australia,Royal Perth Hospital,Perth,Western Australia,Australia

出　　处：《Stroke & Vascular Neurology》2021年第2期207-213,共7页卒中与血管神经病学（英文）

摘　　要：Objective To compare transradial artery access(TRA)to the gold standard of transfemoral artery access(TFA)in mechanical thrombectomy(MT)for stroke caused by anterior circulation large vessel occlusion.Methods The clinical outcomes,procedural speed,angiographic efficacy and safety of both techniques were analysed in 375 consecutive cases over an 18-month period in a high volume statewide neurointerventional service.Results There was no significant difference in patient characteristics,stroke parameters,imaging techniques or intracranial techniques.The median time elapsed between CT scanning and reperfusion was 96.5 min(IQR 68-123)in the TFA group and 95 min(IQR 68-123)in the TRA group(p=0.456).Of 336 patients who were independent at presentation 58%(124/214)of the TFA group and 67%(82/122)of the TRA group had a modified Rankin score of 0-2 at 90-day follow-up(p=0.093).Cross-over from radial to femoral was 4.6%(4/130)compared with 1.6%cross-over from femoral to radial(4/245),but did not meet the predetermined level of statistical significance(OR2.92,95% CI 0.81 to 10.52,p=0.088) and did not impact median procedural speed.Adequate angiographic reperfusion,first pass reperfusion,embolisation to new territory and symptomatic intracranial haemorrhage were similar in both groups.There was a significant difference in major access site complications requiring an additional procedure.None of the TRA cases had a major access site complication but 6.5%(16/245)of the TFA cases did(p=0.003).Conclusion This study suggests that using TRA for anterior circulation MT is fast,efficacious,safe and not inferior to the gold standard of TFA.

关 键 词：service RADIAL CASES 

分 类 号：R741[医药卫生—神经病学与精神病学]