Thrombectomy Using a Method to Directly Insert an Aspiration Catheter into a 6-Fr Sheath-introducer Placed into the Brachial Artery

• Published in: Journal of Neuroendovascular Therapy Vol. 12; no. 9; pp. 456 - 462
• Main Authors: Ishikawa, Osamu, Tsutsumi, Kazuo, Yoshikawa, Gakushi, Saito, Akira, Tsunoda, Sho, Kondo, Erika, Sato, Katsuya, Omura, Takaki, Saito, Nobuhito
• Format: Journal Article
• Language: English
• Published: The Japanese Society for Neuroendovascular Therapy 2018
• Subjects: acute ischemic stroke; aspiration catheter; mechanical thrombectomy; transbrachial approach
• ISSN: 1882-4072; 2186-2494
• DOI: 10.5797/jnet.tn.2018-0001

Objective: For thrombectomy, it is sometimes difficult to advance a guiding catheter using the transfemoral artery approach. In this study, we report five patients in whom intraoperative switching to the transbrachial artery approach led to successful results.Case Presentations: This procedure was performed for five patients in whom it was difficult to guide a catheter using the transfemoral artery approach. A 6-Fr sheath-introducer was newly inserted into the brachial artery, and an aspiration catheter was directly inserted into the sheath’s insertion opening using an attached inserter and advanced to reach a target vessel. Subsequently, thrombectomy with the aspiration method or a stent retriever was conducted, and Thrombolysis in cerebral infarction (TICI) 2b or higher recanalization was achieved in four patients in a relatively short time.Conclusion: The direct aspiration catheter insertion technique using the transbrachial approach may be useful as an alternative method for patients in whom transfemoral approach is difficult.