A191 Transradial sheathless approach using a large-bore guide catheter (0,096″ inner diameter) in 10 stroke cases

Résumé fourni par la source

Background/Introduction Transradial access for mechanical thrombectomy in acute ischemic stroke has emerged as a feasible alternative to the conventional transfemoral approach, particularly in patients with complex aortic arch anatomy. Objective/Purpose This study evaluates the feasibility, technical success, and clinical outcomes of a sheathless large-bore transradial approach using an 8-Fr BMX96 guide catheter. Methods/Case Description The results are presented on this table: We retrospectively analyzed 10 consecutive patients with acute ischemic stroke treated between 2025 and 2026. Inclusion criteria comprised National Institutes of Health Stroke Scale (NIHSS) ≥6 and modified Rankin Scale (mRS) ≤3 prior to stroke. All procedures were performed using a sheathless transradial technique, initially placing a 6–7 Fr low-profile sheath, subsequently exchanged for a coaxial system including the BMX96 guide catheter. Baseline demographic, clinical, and procedural variables were collected, including occlusion site, multiphase CT angiography collateral score, puncture-to-recanalization time, number of passes, eTICI score, and post-procedural outcomes. Results/Findings The cohort demonstrated 100% successful radial access and target vessel catheterization. Median baseline NIHSS was 14 (range 7–21), decreasing to a median of 6 at 24 hours. Median puncture-to-recanalization time was 32.5 minutes (range 5–72), with a median of 2 passes. Successful reperfusion (eTICI ≥2b) was achieved in all cases, with no immediate access-related complications. Anatomical challenges included type II/III aortic arches, bovine arch configurations, and severe brachiocephalic trunk elongation. Tandem occlusions required cervical internal carotid stenting. Discussion/Conclusions/Learning Points Sheathless large-bore transradial access appears to be a safe and effective alternative for mechanical thrombectomy in selected patients, particularly those with unfavorable transfemoral anatomy, offering high recanalization rates and low complication risk.

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