Distal Transradial Approach in Mechanical Thrombectomy: Technical Note

OBJECTIVE: We report a case of mechanical thrombectomy (MT) via the distal transradial approach (dTRA) and technical tips. CASE PRESENTATION: An 89-year-old woman was transferred to our hospital due to back pain after a fall and sudden-onset left hemiparesis. We performed MT because three-dimensional computed tomography angiography (3D-CTA) revealed right middle cerebral artery (MCA) occlusion. The access route was Type 3 aortic arch. The abdominal aorta and common iliac artery were tortuous and partially dissected, and she had a lumbar vertebra fracture. We selected dTRA in consideration of safety, ease of access, and less postoperative postural restriction. The first pass resulted in complete recanalization using an aspiration catheter and stent retriever. Her symptoms rapidly improved and she was discharged with a modified Rankin Scale score of 1. CONCLUSION: dTRA in MT may be a treatment option.