Thrombectomy Using a Method to Directly Insert an Aspiration Catheter into a 6-Fr Sheath-introducer Placed into the Brachial Artery

Abstract

Objective: For thrombectomy, it is sometimes difficult to advance a guiding catheter using the transfemoral artery approach. In this study, we report five patients in whom intraoperative switching to the transbrachial artery approach led to successful results.

Case Presentations: This procedure was performed for five patients in whom it was difficult to guide a catheter using the transfemoral artery approach. A 6-Fr sheath-introducer was newly inserted into the brachial artery, and an aspiration catheter was directly inserted into the sheath’s insertion opening using an attached inserter and advanced to reach a target vessel. Subsequently, thrombectomy with the aspiration method or a stent retriever was conducted, and Thrombolysis in cerebral infarction (TICI) 2b or higher recanalization was achieved in four patients in a relatively short time.

Conclusion: The direct aspiration catheter insertion technique using the transbrachial approach may be useful as an alternative method for patients in whom transfemoral approach is difficult.