Abstract
Neuroendovascular surgery has become an indispensable domain in the treatment of cerebrovascular disease with a slew of treatment options for numerous pathologies. The field experienced a movement toward a transradial approach for diagnostic and interventional procedures. Advantages of the transradial approach include lower risk for complications, which can be fatal using the transfemoral route, higher patient satisfaction, and shorter hospital stays. Those advantages are not unique to the adult population but are, in fact, even more pronounced in pediatrics. They include early mobilization of patients since flat bed rest is not required as it is with transfemoral puncture for hemostasis at the groin. This also obviates the need for continuous intravenous sedatives, which is fraught with its own risks. Early reports have demonstrated the feasibility of transradial cerebral angiography in children. Others have also shown that the transradial approach can be safely used to administer intraarterial chemotherapy in children with retinoblastoma. A standardized protocol is imperative to maximize the success rate of the transradial approach in pediatrics and includes the routine use of ultrasound as well as a “radial cocktail” to avoid vasospasm. While transfemoral may be the conventional route, transradial offers a plethora of advantages, particularly in children. As more experience in transradial is gained in adults, it is likely that this will translate into more transradial procedures in children as well.