Abstract:
Objective To investigate the appropriate classification of super-arch cerebral blood supplying branches in transradial access (TRA) for neurointerventional surgery and evaluate its applicational value.
Methods A total of 186 patients underwent cerebral angiography or treatment between July 2017 and February 2022 were selected. According to the relationships between the pushing force and the support point evaluated using ortic arch angiography or preoperative CTA images, the superarch cerebral blood supplying branches of patients were divided into type 1 (ordinary type), type 2 (moderate difficulty type), and type 3 (difficult type). The success rate and fluoroscopy time of TRA superselection among patients with different types of superarch cerebral blood supplying branches were compared.
Results A total of 394 target blood vessels were included in 186 patients, with164, 151, 79 of type 1, type 2, type 3 vessels, respectively. The superselection success rate in type 1 vessels was 100% (164/164), with an average fluoroscopy time of (6.98±2.19) s, which was 100% (151/151), (7.16±2.40) s, and 81.0% (64/79), (14.32±5.10) s in type 2 and type 3 vessels, respectively. There was a significant difference in the superselection success rate among the three types vessels (P < 0.01). There were statistically significant differences in fluoroscopy time between types 1 and 3 vessels and between types 2 and 3 vessels (P < 0.05).
Conclusions The applicational classifications based on the relationships between the pushing force and the support point may be helpful of optimization of TRA neurointervention treatment strategies. The superselection success rate is related lower in type 3 of target blood vessels, with higher need of special materials and surgical procedures.
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