Transradial Thrombectomy with 6Fr Aspiration Catheters through the 7F Piraeus 87 NeuGlide Catheter: A Single-Center Retrospective Observational Study

When a blood clot blocks a major artery in the brain, the result is an acute ischemic stroke, a medical emergency that can cause permanent disability or death. For years, the standard way to remove such a clot has been to thread a thin tube through an artery in the groin, guiding it up through the body's main vessels to the site of the blockage. While this method works well, it requires the patient to lie flat for hours and carries risks of bruising or bleeding at the groin site. In recent years, doctors have looked to the wrist as an alternative entry point. Accessing the radial artery in the wrist offers a more comfortable experience for patients and allows them to sit up and move sooner. However, a significant technical hurdle has prevented this approach from becoming common for the most dangerous types of strokes: the tubes needed to suck out large clots are too wide to fit through the standard guides used in the wrist.

A team of researchers at the University of North Dakota and Sutter Health set out to see if a new, specialized tube could solve this problem. They tested a system designed to act as a sturdy bridge, allowing a large suction catheter to pass through a guide sheath in the wrist without getting stuck or losing power. In a study of seventeen patients who arrived at their hospital with large clots blocking blood flow to the brain, the team attempted to clear the blockage using this wrist-based approach. The results were promising. In sixteen of the seventeen cases, the doctors successfully navigated the large suction tube through the wrist and into the brain's arteries. They were able to reach the clot and remove it, restoring blood flow in every single patient, including the one case where they eventually had to switch to the groin approach because the wrist route was not feasible.

The procedure was efficient. On average, it took less than ten minutes from the moment the doctor punctured the wrist to the moment they took the first clear image of the target blood vessel. The entire procedure, from start to finish, took about twenty-two minutes on average. Most importantly, the new system did not cause the complications that often worry doctors when using large tools in smaller arteries. There were no instances of the artery tearing, no spasms that narrowed the vessel, and no clots breaking loose and traveling to other parts of the brain. The only side effects observed were minor and expected for this type of high-risk surgery: one patient had a small bleed inside the brain that did not cause new symptoms, and another had a small area of bleeding that was found later but did not cause harm.

The study suggests that the barrier between the comfort of wrist access and the power of large-bore suction is no longer absolute. By using a guide catheter that fits a seven French sheath in the wrist but can hold a six French suction tube, the team demonstrated that doctors can now tackle large clots through the wrist with the same effectiveness as the traditional groin method. While the study involved a small number of patients and was conducted at a single center, the data indicates that this workflow is safe and effective. The researchers found that the new system provided enough support to reach deep into the brain's vascular network, allowing for the removal of clots in the main arteries and even smaller branches. This opens the door for a future where more stroke patients might benefit from a less invasive entry point, reducing recovery time and avoiding the risks associated with groin access, without sacrificing the speed or power needed to save brain tissue.