| Direct Percutaneous Puncture Approach versus Surgical Cutdown Technique for Intracranial Neuroendovascular Procedures: Technical Aspects. | |
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MedLine Citation:
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PMID: 22099561 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVE: To present the authors' experience with a direct transcervical or transbrachial puncture approach in neuroendovascular procedures in which cranial access via the commonly used percutaneous transfemoral route was impossible because of tortuous upstream angioarchitecture. METHODS: During 1992-2007, 23 neuroendovascular procedures were performed in 21 patients via a direct puncture approach. In 12 patients, surgical cutdown (SCD) and cannulation of the targeted artery (carotid, n = 8; vertebral, n = 4) were done. A direct percutaneous puncture (PP) of either the carotid (n = 5) or the brachial (n = 4) artery was done in nine patients. Treated pathologies were as follows: 10 ruptured and 6 unruptured cerebral aneurysms including two stent-assisted coiling and one internal carotid artery (ICA) balloon occlusion, four brain arteriovenous malformations (AVMs) and one carotid cavernous fistula (CCF). RESULTS: Of 21 patients, 19 (90.5%) had a direct puncture introduction of the microcatheter and successful endovascular procedure. No complications related to the technique were encountered either in the PP or in the SCD group. CONCLUSIONS: Transcervical or transbrachial direct puncture accomplished with PP or by SCD is an effective and safe access route in patients in whom neuroendovascular interventions cannot be done transfemorally. In cases where extensive perioperative anticoagulation is mandatory, bleeding at the puncture site may be a serious problem and can be controlled more effectively through an open surgical approach than by percutaneous maneuvers. |
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Authors:
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Christian Dorfer; Harald Standhardt; Andreas Gruber; Heber Ferraz-Leite; Engelbert Knosp; Gerhard Bavinzski |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-11-16 |
Journal Detail:
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Title: World neurosurgery Volume: - ISSN: 1878-8750 ISO Abbreviation: - Publication Date: 2011 Nov |
Date Detail:
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Created Date: 2011-11-21 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101528275 Medline TA: World Neurosurg Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Neurosurgery, Medical University of Vienna, Vienna, Austria. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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