P-038 Distal transradial access for neuroangiography and interventions
Bibliographic record
Abstract
Background and Purpose Radial arterial access has been shown to improve overall safety in patients undergoing angiography and endovascular therapy. This approach, widely adopted in Cardiology, has recently also been validated for neuroendovascular procedures. Distal trans-radial access via the anatomical snuffbox is a further refinement of this technique with a potential benefit of additional improvement of the overall safety profile. The goal of our study was to review the use of this technique for transradial Neuroendovascular procedures at our institute, in a retrospective manner. Materials and Methods The study included all patients who underwent any Neuroendovascular procedure where the distal radial access technique was used as a primary access site. Cases were included during the study period from July 2019 to February 2022. Procedural details such as femoral conversion rates, and fluoroscopy time were documented for each patient. All complications were recorded and special attention was paid to those that were deemed definitively related to the access site. Results 271 patients were included in the study. During the study period, 285 distal radial access sites were obtained for 282 procedures performed (3 patients had bilateral distal radial access obtained). There were 141 male patients and 130 female patients with a mean age of 59.5 years (Median 61; Range 19–92). 9 patients underwent two procedures on separate occasions and one patient underwent three procedures. Of the 282 procedures performed, 142 procedures were for diagnostic angiography and 140 were for endovascular interventions. Access was obtained in all cases using ultrasound guidance. There were 7 instances of radial artery occlusion among 283 access sites (2.5%), all of them occurring in the interventional group. No patient had symptomatic hand ischemia. Two patients had cerebral ischemic symptoms confirmed on DWI-MR imaging. Mean fluoroscopy time was 32.02 minutes in the interventional group and 12.47 minutes in the DSA group. 6 patients in the interventional arm required conversion to femoral access (4.3%) and one patient in the DSA group (0.7%), for a total femoral conversion rate of 2.5%. Conclusions Distal trans-radial access is a relatively safe technique for patients undergoing a wide range of neuroendovascular procedures. This may be considered as a safe approach for any center looking to adopt radial access for neuroendovascular procedures. The results need validation in a randomized control trial to assess for an increased safety profile when compared to conventional radial access. Disclosures M. Suheel Abdul Salam: None. A. Mitha: None. M. Almekhlafi: None. J. Wong: None. M. Eesa: None.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.017 | 0.004 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".