Abstract
Radial access has rapidly gained popularity in the neurointervention world, building
on its proven success in cardiovascular procedures. Radial access is currently used
for a variety of neurointervention procedures, such as diagnostic cerebral angiography,
aneurysm embolization, and mechanical thrombectomy due to a proven strong safety profile,
patient-preferred alternative to traditional femoral access, faster ambulation, and
fewer access-site complications. Additionally, the radial approach has proven effective
for navigating particularly challenging arches not suitable for the femoral approach,
posterior circulation interventions, and select acute ischemic stroke thrombectomy
cases. Advances in the radial access technique, such as the distal radial access approach
in the anatomical snuffbox, development of specialized access catheters, long radial
sheaths to mitigate spasm, and refined hemostasis techniques have improved its feasibility,
broadened its applicability to be routinely used in neurointervention procedures,
and increased its utilization in cases with challenging aortic arch anatomy. Meta-analyses
have reported high technical success (around 97%) with low crossover (approximately
5%) and minimal complications. This review highlights the latest evidence on radial
access in neurointervention, focusing on technical tips, appropriate patient selection,
clinical applications, as well as complication management.
Keywords
radial access - neurointervention - stroke thrombectomy - cerebral angiography - distal
radial access - aortic arch anatomy
