Abstract：
Aberrant right subclavian artery (ARSA) is a rare condition, but the most common anomaly of the aortic arch. Although neurointerventions via transradial access (TRA) are becoming increasingly popular worldwide, transradial carotid cannulation has been extremely challenging in patients with an ARSA. Herein, we present a case of ARSA-associated anterior communicating artery (ACoA) aneurysm that was successfully treated with a radial-specific 6F Simmons guiding sheath via left TRA. We also review the relevant literature.
A 68-year-old-woman who was diagnosed as having an ARSA-associated ACoA aneurysm underwent simple coiling via left TRA. After the 6F Simmons guiding sheath was engaged into the right common carotid artery using the pull-back-technique, transradial quadraxial system (6F Simmons guiding sheath/6F intermediate catheter/3.2F intermediate catheter/coil-delivery microcatheter) was implemented.
Simple coiling of the aneurysm was successfully achieved without catheter kinking or system instability. The postprocedural course was uneventful. A follow-up magnetic resonance angiography showed no evidence of recanalization 1 years 9 months after the procedure.
Transradial anterior circulation intervention has been rarely used for patients with an ARSA due to unfavorable catheter trajectory. Left TRA using the 6F Simmons guiding sheath is a useful treatment option to address anterior circulation interventions for patients with an ARSA. Preoperative diagnosis of ARSA is necessary for the application of our method.
A 68-year-old-woman who was diagnosed as having an ARSA-associated ACoA aneurysm underwent simple coiling via left TRA. After the 6F Simmons guiding sheath was engaged into the right common carotid artery using the pull-back-technique, transradial quadraxial system (6F Simmons guiding sheath/6F intermediate catheter/3.2F intermediate catheter/coil-delivery microcatheter) was implemented.
Simple coiling of the aneurysm was successfully achieved without catheter kinking or system instability. The postprocedural course was uneventful. A follow-up magnetic resonance angiography showed no evidence of recanalization 1 years 9 months after the procedure.
Transradial anterior circulation intervention has been rarely used for patients with an ARSA due to unfavorable catheter trajectory. Left TRA using the 6F Simmons guiding sheath is a useful treatment option to address anterior circulation interventions for patients with an ARSA. Preoperative diagnosis of ARSA is necessary for the application of our method.
摘要：
背景：右锁骨下动脉异常（ARSA）是一种罕见的疾病，但主动脉弓最常见的异常.尽管通过经桡动脉通路（TRA）的神经干预在世界范围内变得越来越流行，经桡动脉颈动脉插管在ARSA患者中极具挑战性。在这里，我们介绍了1例ARSA相关的前交通动脉(ACoA)动脉瘤,该动脉瘤经左侧TRA用径向特异性6FSimmons导鞘成功治疗.我们还回顾了相关文献。
方法：一名被诊断为ARSA相关ACoA动脉瘤的68岁女性患者通过左侧TRA进行了简单的盘绕。在使用拉回技术将6FSimmons引导鞘插入右颈总动脉后，实施了经桡动脉四端系统(6FSimmons引导鞘管/6F中间导管/3.2F中间导管/线圈输送微导管)。
结果：成功实现了动脉瘤的简单盘绕，没有导管扭结或系统不稳定。程序后课程顺利。随访磁共振血管造影显示，手术后1年9个月没有再通的证据。
结论：由于导管轨迹不利，经桡动脉前循环介入治疗很少用于ARSA患者。使用6FSimmons引导鞘的左TRA是解决ARSA患者的前循环干预的有用治疗选择。术前诊断ARSA是应用我们方法所必需的。
方法：一名被诊断为ARSA相关ACoA动脉瘤的68岁女性患者通过左侧TRA进行了简单的盘绕。在使用拉回技术将6FSimmons引导鞘插入右颈总动脉后，实施了经桡动脉四端系统(6FSimmons引导鞘管/6F中间导管/3.2F中间导管/线圈输送微导管)。
结果：成功实现了动脉瘤的简单盘绕，没有导管扭结或系统不稳定。程序后课程顺利。随访磁共振血管造影显示，手术后1年9个月没有再通的证据。
结论：由于导管轨迹不利，经桡动脉前循环介入治疗很少用于ARSA患者。使用6FSimmons引导鞘的左TRA是解决ARSA患者的前循环干预的有用治疗选择。术前诊断ARSA是应用我们方法所必需的。
