Abstract
BackgroundThe transradial approach (TRA) for neuroendovascular procedures has gained popularity. There is limited data on the use of large‐bore guide catheters in radial approaches. This study evaluates the safety and efficacy of the Ballast 088 long sheath in radial neurointerventional procedures.MethodsWe performed a retrospective review of a prospectively maintained neuroendovascular database to assess the Ballast radial access system (Balt USA, LLC) in radial approaches. The primary outcome was technical success, defined as the access catheter reaching its target vessel and completing the procedure without necessitating a shift to femoral access or changing to a different catheter. Safety outcomes included access site complications and periprocedural device‐related complications.ResultsThere were 138 consecutive patients included in the study. The mean age was 66.7 years (SD ± 15.1); 41.3% were female. The most common interventions were mechanical thrombectomy for ischemic stroke (31.4%), carotid stenting for stenosis (24.6%), and aneurysm embolization (22%). Challenging anatomic variations included severe vessel tortuosity, type 2 and 3 aortic arch, bovine arch, and a severe angle (<30°) between the subclavian artery and the target vessel. Technical success, defined as reaching the target vessel and successfully completing the procedure without necessitating a shift to femoral access or changing the guide catheter, was achieved in 97.8% of the cases (135/138). Three cases (2.2%) required access conversion from radial to femoral. There was one access site complication (temporary spasm; 0.7%) and no device‐related complications. There was only one non‐catheter‐related periprocedural complication.ConclusionThe use of the Ballast radial access system proved to be safe and feasible. It was successful in treating a wide range of interventional procedures, consistently achieving favorable outcomes via radial access.