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Multicenter Study
. 2021 Apr;13(4):357-362.
doi: 10.1136/neurintsurg-2020-017102. Epub 2021 Feb 16.

Upper extremity transvenous access for neuroendovascular procedures: an international multicenter case series

Isaac Josh Abecassis  1 , Vasu Saini  2   3 , Timothy John Phillips  4 , Joshua W Osbun  5 , Mario Martínez-Galdámez  6 , Ahmed Nada  2   7 , Michael R Levitt  8 , R Webster Crowley  9 , Mithun G Sattur  10 , Alejandro M Spiotta  10 , Evan Luther  2 , Stephanie H Chen  2 , Joshua Burks  2 , Pascal Jabbour  11 , Ahmad Sweid  11 , Marios N Psychogios  12 , Min S Park  13 , Dileep R Yavagal  2   3 , Eric C Peterson  2 , Muhammad Waqas  14 , Rimal Hanif Dossani  14 , Jason M Davies  14 , Alex Brehm  12 , Gregory D Selkirk  4 , W Christopher Fox  15 , Daniel Giansante Abud  16 , Jorge Galvan Fernandez  17 , Miguel Schüller Arteaga  17 , Robert M Starke  2
Affiliations
Multicenter Study

Upper extremity transvenous access for neuroendovascular procedures: an international multicenter case series

Isaac Josh Abecassis et al. J Neurointerv Surg. 2021 Apr.

Abstract

Background: Radial artery access for transarterial procedures has gained recent traction in neurointerventional due to decreased patient morbidity, technical feasibility, and improved patient satisfaction. Upper extremity transvenous access (UETV) has recently emerged as an alternative strategy for the neurointerventionalist, but data are limited. Our objective was to quantify the use of UETV access in neurointerventions and to measure failure and complication rates.

Methods: An international multicenter retrospective review of medical records for patients undergoing UETV neurointerventions or diagnostic procedures was performed. We also present our institutional protocol for obtaining UETV and review the existing literature.

Results: One hundred and thirteen patients underwent a total of 147 attempted UETV procedures at 13 centers. The most common site of entry was the right basilic vein. There were 21 repeat puncture events into the same vein following the primary diagnostic procedure for secondary interventional procedures without difficulty. There were two minor complications (1.4%) and five failures (ie, conversion to femoral vein access) (3.4%).

Conclusions: UETV is safe and technically feasible for diagnostic and neurointerventional procedures. Further studies are needed to determine the benefit over alternative venous access sites and the effect on patient satisfaction.

Keywords: angiography; intervention; technique.

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Conflict of interest statement

Competing interests: RMS: research is supported by the NREF, Joe Niekro Foundation, Brain Aneurysm Foundation, Bee Foundation, and by the National Institute of Health (R01NS111119-01A1) and (UL1TR002736, KL2TR002737) through the Miami Clinical and Translational Science Institute, from the National Center for Advancing Translational Sciences and the National Institute on Minority Health and Health Disparities. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. RMS has an unrestricted research grant from Medtronic and has consulting and teaching agreements with Penumbra, Abbott, Medtronic, InNeuroCo, and Cerenovus.

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