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Direct Radial Artery Access With the 070 Neuron Guide Catheter for Aneurysm Coiling: A Novel Application of the Neuron Catheter for Cerebral Interventions

Lawson, Matthew F. MD*,‡; Velat, Gregory J. MD*; Fargen, Kyle M. MD*; Hoh, Brian L. MD*; Mocco, J MD, MS§

doi: 10.1227/NEU.0b013e318265a454
Technical Case Report

BACKGROUND AND IMPORTANCE: Most neuroendovascular interventions rely on a transfemoral approach to the intracranial circulation; however, this is sometimes not possible because of complex aortic arch anatomy or femoral arterial disease. Transradial arteriography and intervention are well established in interventional cardiology, and there have been some reports of successful neurointervention using this technique. The incidence of radial artery occlusion or other access site complications after transradial access is directly related to the outer diameter of the sheath used to access the artery. We describe a novel approach to neuroendovascular intervention using a 070 Neuron guide catheter to directly access the radial artery for complex cerebrovascular intervention.

CLINICAL PRESENTATION: We describe a technique to directly access the radial artery with a 070 Neuron catheter, without the need for a large 6-French sheath, for cerebrovascular interventions. Two successful cases are described in which this technique was used. Case 1 describes the successful Y-stent placement for coiling of a basilar tip aneurysm, and case 2 describes coiling of a ruptured posterior inferior cerebellar artery aneurysm.

CONCLUSION: The 070 Neuron catheter can be used in a direct access transradial approach to the cerebrovascular circulation for complex interventions without a radial sheath, thereby maximizing guide catheter diameter and minimizing the radial arteriotomy size.

*Department of Neurosurgery, University of Florida, Gainesville, Florida

Tallahassee Neurological Clinic, Tallahassee, Florida

§Department of Neurosurgery, Vanderbilt University, Nashville, Tennessee

Correspondence: Matthew F. Lawson, MD, 1401 Centerville Road, Suite 300, Tallahassee, FL 32308. E-mail: mflpublications@yahoo.com

Received March 29, 2012

Accepted June 6, 2012

Copyright © by the Congress of Neurological Surgeons