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.
Highlights
BackgroundWith a prevalence of approximately 3% in the United States, stroke is the primary reason for long-term disability and the fourth leading cause of death [1]
The majority of acute ischemic stroke is due to large vessel occlusion in the anterior circulation, most frequently the internal carotid artery [6,7]
The commonly used methods are the transfemoral and transradial approaches for endovascular mechanical thrombectomy (MT), which is employed during acute ischemic stroke due to large vessel intracranial occlusion [8]
Summary
BackgroundWith a prevalence of approximately 3% in the United States, stroke is the primary reason for long-term disability and the fourth leading cause of death [1]. The majority of acute ischemic stroke is due to large vessel occlusion in the anterior circulation, most frequently the internal carotid artery [6,7]. The commonly used methods are the transfemoral and transradial approaches for endovascular mechanical thrombectomy (MT), which is employed during acute ischemic stroke due to large vessel intracranial occlusion [8]. MT involves the delivery of a device into the affected blood vessel in the brain, typically through a catheter via the femoral artery, which navigates toward the clot's location within the neurovasculature. This device is used to capture and remove the clot [9]. MT has become the standard of care in the management of emergent
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