Mechanical Thrombectomy in Patients With Acute Ischemic Stroke: A Comparison of Transradial Versus Transfemoral Cerebral Angiography

Mohammad R Ghani, Vishal Busa, Ahmed Dardeir, Suganya Marudhai, Mauli Patel, Yousif M Abdelmoneim, Ahmad Jan, Noha Eskander, Mohammad R Ghani, Vishal Busa, Ahmed Dardeir, Suganya Marudhai, Mauli Patel, Yousif M Abdelmoneim, Ahmad Jan, Noha Eskander

Abstract

Stroke is the fourth leading cause of death in the United States and the primary reason for long-term disability. This debilitating condition can be divided into ischemic stroke and hemorrhagic stroke. The former occurs in almost 90% of all cases and arises from the occlusion of the supplying artery. Over the years, the management of stroke has developed from solely medical treatment to that which combines medical with mechanical treatment. Mechanical thrombectomy (MT) has drawn considerable interest in advanced medicine and is becoming more widely available. The two fundamental techniques in opening an occluded vessel are the transfemoral and transradial approaches. This literature review aims to compare the clinical implications, complication rate, and overall outcome between the transfemoral and transradial approaches in endovascular intervention in patients with acute ischemic stroke. We conducted a literature review on ischemic stroke and searched PubMed and Google Scholar for relevant articles published from January 2010 to March 2020. Mechanical thrombectomy has become the standard of care for patients with brain ischemia. The transradial approach exhibited superiority to the transfemoral route in resolving symptoms, decreased complication rates, and reduced healthcare costs in a subset of patients. In this literature review, the comparison between the two procedures reveals that the outcomes for anterior circulation stroke and posterior vascular system stroke may vary. Further research needs to be conducted to improve procedural skills and decrease technical difficulties, ultimately resulting in improved overall patient outcomes with respect to health and comfort.

Keywords: acute ischemic stroke; cerebrovascular disease; mechanical thrombectomy; transfemoral access; transradial access.

Conflict of interest statement

The authors have declared that no competing interests exist.

Copyright © 2020, Ghani et al.

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Source: PubMed

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