Critical thinking of transradial access in neurointerventional surgery

Transradial access has been more and more used in the neurointerventional surgery nerve interventional therapy, with the advantages of fewer complications and higher satisfaction. However, it has the disadvantages and difficulties of long learning curve, be limited by anatomical factors of radial artery and upper shoulder vessels, and lack of special instruments for nerve intervention. There are few absolute contraindications to the transradial approach, and the distal and the left radial approachs are increasingly used as the choices of approach. The transradial access without sheath or with larger-lumen sheath and the combination of materials are helpful to carry out various nerve intervention operations. However, in the absence of high-level evidence, there are difficulties and challenges in the interventional treatments of intracranial aneurysms, carotid artery stenting and mechanical thrombectomy. A scientific and cautious attitude is needed in neurointerventional surgery by the transradial access.