To the Editor:
I would like to comment about the recent article published in Operative Neurosurgery, “Transradial approach for complex anterior and posterior circulation interventions: technical nuances and feasibility of using current devices.”1 This is a very interesting article about a series of 105 procedures performed in 92 patients, among which there were 29 thrombectomies, 33 embolizations of cerebral aneurysms, and 33 other procedures performed using the transradial approach as the first option. The technique used, complications observed, and results attained are all clearly described, making this paper an important contribution to the literature supporting this approach's use for multiple endovascular treatments. However, in the Introduction, the authors comment how the literature on transradial approach used for neurointerventional procedures is limited to small series that primarily focused on posterior circuit lesions or previous failed transfemoral procedures. To justify this statement, the authors refer to a paper that we published, last year, describing 40 treated aneurysms.2 However, of these 40 patients, 39 had lesions in the anterior circuit and only one the posterior circuit; and all procedures were performed using the transradial approach as our first option2. This correction notwithstanding, I congratulate the authors for the work they have presented in your journal and agree with their conclusion that the transradial approach has a definite role in neurointerventional procedures.
The author has no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article.
1. Snelling BM, Sur S, Shah SS, Caplan J, Khandelwal P, Yavagal DR, Starke RM, Peterson EC. Transradial approach for complex anterior and posterior circulation interventions: technical nuances and feasibility of using current devices. Oper Neurosurg. published online: November 28, 2018. (https://doi.org/10.1093/ons/opy352
2. Goland J, Doroszuk GF, Garbugino SL, Ypa MP. Transradial approach to treating endovascular cerebral aneurysms: case series and technical note. Surg Neurol Int. 2017;8(1):73.