Retained radial catheters associated with variant radial anatomy in neurointerventional procedures

Authors

Joshua S. Catapano, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA.Follow
Ethan A. Winkler, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA.
Visish M. Srinivasan, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA.
Evan L. Dishion, Department of Neurology, Barrow Neurological Institute, Phoenix, Arizona, USA.
Caleb Rutledge, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA.
Jacob F. Baranoski, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA.Follow
Tyler S. Cole, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA.Follow
Robert F. Rudy, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA.
Kavelin Rumalla, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA.
Martin P. Zomaya, The University of Arizona College of Medicine Phoenix, Phoenix, Arizona, USA.
Ashutosh P. Jadhav, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA.Follow
Andrew F. Ducruet, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA.
Felipe C. Albuquerque, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA Neuropub@Barrowneuro.org.Follow

Document Type

Article

Abstract

BACKGROUND: Transradial artery access (TRA) for neurointerventional procedures is gaining widespread acceptance. However, complications that were previously rare may arise as TRA procedures increase. Here we report a series of retained catheter cases with a literature review. METHODS: All patients who underwent a neurointerventional procedure during a 23-month period at a single institution were retrospectively reviewed for a retained catheter in TRA cases. In cases of retained catheters, imaging was reviewed for anatomical variances in the radial artery, and clinical and demographic case details were analyzed. RESULTS: A total of 1386 nondiagnostic neurointerventional procedures were performed during the study period, 631 (46%) initially via TRA. The 631 TRA cases were performed for aneurysm embolization (n=221, 35%), mechanical thrombectomy (n=116, 18%), carotid stent/angioplasty (n=40, 6%), arteriovenous malformation embolization (n=38, 6%), and other reasons (n=216, 34%). Thirty-nine (6%) TRA procedures crossed over to femoral access, most commonly because the artery of interest could not be catheterized (26/39, 67%). A retained catheter was identified in five cases (1%), and one (0.2%) patient had an entrapped catheter that was recovered. All six patients with a retained or entrapped catheter had aberrant radial anatomy. CONCLUSION: Retained catheters for neurointerventional procedures performed via TRA are rare. However, this complication may be associated with variant radial anatomy. With the increased use of TRA for neurointerventional procedures, awareness of anatomical abnormalities that may lead to a retained catheter is necessary. We propose a simple protocol to avoid catheter entrapment, including in emergent situations such as TRA for stroke thrombectomy.

Publication Date

9-9-2022

Publication Title

Journal of neurointerventional surgery

E-ISSN

1759-8486

PubMed ID

36190952

Digital Object Identifier (DOI)

10.1136/jnis-2022-019004

Recommended Citation

Catapano, Joshua S.; Winkler, Ethan A.; Srinivasan, Visish M.; Dishion, Evan L.; Rutledge, Caleb; Baranoski, Jacob F.; Cole, Tyler S.; Rudy, Robert F.; Rumalla, Kavelin; Zomaya, Martin P.; Jadhav, Ashutosh P.; Ducruet, Andrew F.; and Albuquerque, Felipe C., "Retained radial catheters associated with variant radial anatomy in neurointerventional procedures" (2022). Translational Neuroscience. 2284.
https://scholar.barrowneuro.org/neurobiology/2284