Minimally Invasive Therapy & Allied Technologies最新文献

{"title":"Ventral hernia repair in emergency settings. A machine learning model to predict post-operative complications.","authors":"Monica Ortenzi, Lorenzo Crepaz, Gabriele Anania, Andrea Balla, Salvador Morales-Conde, Manuela Mastronardi, Alberto Arezzo, Mauro Podda, Danila Azzolina","doi":"10.1080/13645706.2026.2665459","DOIUrl":"https://doi.org/10.1080/13645706.2026.2665459","url":null,"abstract":"<p><strong>Background: </strong>Emergency ventral hernia repair remains a challenging procedure due to patient instability, contaminated surgical fields, and heterogeneity in hernia types and operative techniques. Predicting postoperative complications in this setting is difficult using traditional statistical methods. Machine learning (ML) may offer improved predictive accuracy by recognizing nonlinear patterns among multiple perioperative factors.</p><p><strong>Methods: </strong>A retrospective multicenter analysis was performed using data from the ACTIVE (Acute Treatment for Incisional Ventral Hernias) study, including 557 adult patients undergoing emergent ventral hernia repair between 2018 and 2021 in 31 Italian surgical centers. Demographic, preoperative, intraoperative, and postoperative variables were analyzed. Three ML algorithms-Decision Tree, Random Forest, and Deep Learning Neural Network-were trained and validated using five-fold cross-validation after class balancing with SMOTE. Model performance was compared with traditional logistic regression using accuracy, area under the ROC curve (AUC), and F1 score.</p><p><strong>Results: </strong>Postoperative complications occurred in 181 patients (32.5%), while major complications (Clavien-Dindo ≥ II) occurred in 10%. Random Forest achieved the best performance (AUC 0.95, accuracy 0.88, F1 score 0.86), outperforming logistic regression (AUC 0.82, accuracy 0.78). The most influential predictors were operative duration, ASA score, and sepsis for overall complications, while bowel obstruction and BMI were key factors for major complications. Surgical approach (open vs. laparoscopic) did not independently correlate with adverse outcomes, highlighting the complexity of patient- and case-specific interactions.</p><p><strong>Conclusions: </strong>Machine learning models can accurately predict postoperative complications following emergent ventral hernia repair, surpassing traditional regression methods. These findings suggest that ML-based decision tools could support risk stratification and optimize surgical planning in high-risk emergency settings. Prospective validation is warranted to integrate AI-assisted prediction into perioperative clinical workflows.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"1-12"},"PeriodicalIF":2.0,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147840031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term impact of the 'Marginal Gains' standardised workflow for laparoscopic right hemicolectomy with complete mesocolic excision (CME): a pre- and post-implementation study.","authors":"Salvador Morales-Conde, Andrea Scammon Duran, Javier Valdes-Hernandez, Juan Carlos Gómez-Rosado, Pietro Mascagni, Juan Cintas Catena, Andrea Balla","doi":"10.1080/13645706.2026.2668522","DOIUrl":"https://doi.org/10.1080/13645706.2026.2668522","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the implementation and clinical impact of a standardised workflow for laparoscopic right hemicolectomy (LRH) with complete mesocolon excision (CME) using a cranial approach in colon cancer, the so-called 'Marginal Gains' project.</p><p><strong>Methods: </strong>This is a single-centre retrospective before-and-after cohort study of prospectively collected data. Outcomes of 29 patients undergoing LRH from 2022 to 2023 (control group) were compared with 34 patients treated between 2023 and 2024, after implementation of a structured CME-oriented workflow (intervention group). The primary outcome was the rate of workflow application and its clinical impact (secondary outcomes) in terms of CME rate (performed when clinically indicated), intraoperative events, 30-day postoperative complications, and lymph nodes harvested.</p><p><strong>Results: </strong>Baseline characteristics were comparable between groups. Workflow was applied in all cases. CME, performed according to predefined clinical criteria, was more frequent in the intervention group (13/34, 38.2%) than in the control group (1/29, 3.4%; <i>p</i> = .001), reflecting structured workflow adoption and potentially introducing selection bias. Overall postoperative complications occurred in 6/34 (17.6%) patients in the intervention group and 13/29 (44.8%) in the control group (<i>p</i> = .027), mainly driven by low-grade (Clavien I-II) events, particularly paralytic ileus (0 vs. 4 cases) and minor anastomotic bleeding (0 vs. 4 cases). One anastomotic leak occurred in the intervention group (2.9%), requiring reoperation with redo anastomosis (Clavien III-b). No significant differences were observed in tumour stage. The mean number of harvested lymph nodes was higher in the intervention group (22.18 ± 6 vs. 18.83 ± 6.50; <i>p</i> = .021).</p><p><strong>Conclusions: </strong>Implementation of the standardised CME-oriented workflow was feasible and associated with lower short-term postoperative morbidity and higher lymph node harvest. Given the non-randomised before-and-after design and limited sample size, these findings should be considered exploratory and hypothesis-generating rather than evidence of definitive improvement in surgical or oncological outcomes. Prospective multicentre validation is warranted.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"1-8"},"PeriodicalIF":2.0,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147840034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transvaginal versus transabdominal extraction techniques in laparoscopic surgery: a systematic review and meta-analysis.","authors":"Liliana Galli, Laura Luka, Massimo Piergiuseppe Franchi, Pier Carlo Zorzato, Anna Festi, Alberta Ricci, Francesca Magni, Antonio Simone Laganá, Mariachiara Bosco, Stefano Uccella, Simone Garzon","doi":"10.1080/13645706.2026.2653713","DOIUrl":"https://doi.org/10.1080/13645706.2026.2653713","url":null,"abstract":"<p><strong>Background: </strong>In laparoscopic surgery, specimen retrieval can require enlarging abdominal incisions, reducing the minimally invasive benefits. Transvaginal specimen extraction (TVSE) can offer a safer, more cosmetic alternative for women. This systematic review and meta-analysis evaluated the safety and outcomes of TVSE compared with transabdominal extraction, regardless of surgical indication.</p><p><strong>Methods: </strong>EMBASE, Scopus, PubMed, MEDLINE, Web of Science, and the Cochrane Library were searched from inception to April 2025. Studies were grouped by design, surgical specialty, and extraction method (port enlargement versus mini-laparotomy) to explore heterogeneity.</p><p><strong>Results: </strong>Twenty-five studies were included for 2751 patients (1144 TVSE, 1607 transabdominal extraction) in general, urologic, or gynecologic surgery. TVSE was associated with lower postoperative pain (mean difference -0.98, 95%CI -1.30 to -0.66), rescue analgesia use (OR 0.38, 95%CI 0.28 to 0.51), postoperative complications (OR 0.55, 95%CI 0.34 to 0.89), shorter hospital stays (mean difference -1.04, 95%CI -1.77 to -0.30), and higher cosmetic satisfaction (mean difference 0.91, 95% CI 0.46 to 1.35), especially versus mini-laparotomy. Blood loss, intraoperative complications, and dyspareunia did not differ.</p><p><strong>Conclusion: </strong>TVSE is associated with improved postoperative outcomes when it replaces mini-laparotomy, whereas less benefit is observed versus laparoscopic port-site enlargement. Further randomized controlled trials are needed to confirm these findings.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"1-23"},"PeriodicalIF":2.0,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact and costs of 3D virtual models in minimally invasive partial nephrectomy: a propensity score-matched analysis.","authors":"Marco Oderda, Federico Lavagno, Marco Allasia, Glauco Bertello, Simona Ingrassano, Carlotta Mangione, Olivia Smyk, Alberto Vignola, Francesco Soria, Paolo Gontero","doi":"10.1080/13645706.2026.2651328","DOIUrl":"https://doi.org/10.1080/13645706.2026.2651328","url":null,"abstract":"<p><strong>Background: </strong>Three-dimensional (3D) virtual models are increasingly used to support minimally invasive partial nephrectomy (PN), but their clinical value remains uncertain. We assessed whether 3D guidance improves perioperative, oncological, and early functional outcomes and evaluated its cost.</p><p><strong>Methods: </strong>We retrospectively analyzed 159 patients who underwent laparoscopic or robot-assisted PN between 2022 and 2024. Propensity score matching generated two comparable groups (35 patients each) treated with or without 3D virtual model guidance, according to age, PADUA score, and surgical approach. Perioperative, pathological, early oncological, and early functional outcomes were compared using non-parametric tests.</p><p><strong>Results: </strong>Although matching improved comparability, some residual imbalance remained. The 3D group had longer operative times (median 200 vs 170 min; p=0.008). No significant differences were found in clamping strategy, warm ischemia time, estimated blood loss, hospital stay, pathological stage, surgical margins, postoperative complications, or early recurrence. Changes in haemoglobin, serum creatinine, and estimated glomerular filtration rate from baseline to discharge were similar between groups. Each 3D virtual model cost €800.</p><p><strong>Conclusions: </strong>In this propensity score-matched cohort, 3D virtual model guidance during minimally invasive PN was associated with longer operative time, added cost, and no measurable benefit in perioperative, oncological, or early functional outcomes.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"1-7"},"PeriodicalIF":2.0,"publicationDate":"2026-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147817201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ejaculation-sparing GreenLight anatomical PVP versus REZŪM for benign prostatic obstruction surgery with an ejaculation-sparing purpose: what are the early differences?","authors":"Paolo Destefanis, Mattia Sibona, Marco Oderda, Eugenia Vercelli, Gabriele Montefusco, Fulvia Colucci, Matteo Ghio, Paolo Gontero","doi":"10.1080/13645706.2026.2656310","DOIUrl":"https://doi.org/10.1080/13645706.2026.2656310","url":null,"abstract":"<p><strong>Background: </strong>Surgery for benign prostatic obstruction (BPO) is often associated with postoperative ejaculatory dysfunction. Traditional techniques like transurethral resection of the prostate (TUR-P) or open prostatectomy (OP) effectively relieve lower urinary tract symptoms (LUTS) but usually compromise antegrade ejaculation. Minimally invasive surgical techniques (MISTs), such as Rezūm^® or modified endoscopic surgeries, like the ejaculation-sparing anatomical photoselective vaporization of the prostate (ESa-PVP), were developed to preserve sexual function while ensuring symptom relief. However, few comparative data are available. Our study aims to compare the early functional and sexual outcomes of Rezūm^® and ESa-PVP in BPO.</p><p><strong>Methods: </strong>This prospective, non-randomised study analysed two cohorts of men with LUTS unresponsive to medication or an indwelling catheter, surgically treated at our centre between December 2022 and December 2023. The primary outcome of the study was the assessment of postoperative antegrade ejaculation. Secondary outcomes included LUTS evaluation and surgical complications. Postoperative outcomes were assessed after three months by administering validated questionnaires: International Prostate Symptom Score (IPSS), International Index of Erectile Function-5 (IIEF-5), and Male Sexual Health Questionnaire-Ejaculatory Dysfunction, short form (MSHQ-EjD).</p><p><strong>Results: </strong>A total of 54 patients were evaluated (31 Rezūm, 23 ESa-PVP). After three months, the ESa-PVP showed a better improvement of both IPSS scores (<i>p</i> = 0.009) and patient-perceived quality of life (<i>p</i> = 0.008). No significant differences were found in erectile function (IIEF-5 scores, <i>p</i> = 0.340), while the MSHQ-EjD scores were significantly higher in the Rezūm group (<i>p</i> = 0.001). Ejaculation was maintained in 26 out of 31 (83%) Rezūm patients versus 14 out of 23 (60%) ESa-PVP patients (<i>p</i> = 0.056).</p><p><strong>Conclusions: </strong>Rezūm^® and ESa-PVP are both effective and safe procedures for the treatment of BPO. While the ESa-PVP seems to provide better symptom relief in the short term, Rezūm^® showed higher rates of immediate antegrade ejaculation preservation. Personalised counselling is crucial to achieve optimal patient satisfaction.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"1-9"},"PeriodicalIF":2.0,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147776128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From minimal access to intelligent intervention: retracing the history of MITAT.","authors":"Alberto Arezzo","doi":"10.1080/13645706.2026.2658062","DOIUrl":"https://doi.org/10.1080/13645706.2026.2658062","url":null,"abstract":"","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"1-3"},"PeriodicalIF":2.0,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and effectiveness of a piezoelectric ultrasonic bone cutter for cervical corpectomy: a pilot study in rabbits.","authors":"Mosharraf Hossain, Tamima Sultana, Je Hoon Jeong, Byong-Taek Lee, Soobin Im","doi":"10.1080/13645706.2026.2650191","DOIUrl":"https://doi.org/10.1080/13645706.2026.2650191","url":null,"abstract":"<p><strong>Background: </strong>Piezosurgery has emerged as an innovative technique with minimal soft tissue injury, making it useful for complex spinal procedures. However, its efficacy in small-animal spinal surgery needs further evaluation. This study assessed the safety and effectiveness of a piezoelectric ultrasonic bone cutter (PUBC) in a rabbit vertebral defect model.</p><p><strong>Methods: </strong>Twenty New Zealand white rabbits were assigned to two groups: one undergoing surgery with a traditional rotary drill (TRD) and the other with a PUBC device. Cervical corpectomy defects were created using the respective osteotomy tools, and intraoperative and postoperative complications were carefully monitored.</p><p><strong>Results: </strong>Three rabbits (3/10, 30%) in the TRD group experienced both intraoperative and postoperative complications, whereas no complications were observed in the PUBC group. Compared to the TRD, the PUBC device minimized bleeding and effectively protected surrounding soft tissue structures from damage. Additionally, the PUBC produced more uniform and precise bone defects, potentially facilitating proper bone graft implantation. However, micro-computed tomography and histological analysis revealed no significant differences in bone healing between the devices.</p><p><strong>Conclusions: </strong>This study suggests that the PUBC is a safe and effective tool for spinal surgery in small animal models, and can be used as an alternative approach to the TRD device.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"1-11"},"PeriodicalIF":2.0,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic management of invasive retained products of conception: a case series.","authors":"Michal Mára, Marie Švehelková, Zdeňka Lisá, Vojtěch Lukavec, Kristýna Hlinecká, Zdeněk Žižka","doi":"10.1080/13645706.2026.2653199","DOIUrl":"https://doi.org/10.1080/13645706.2026.2653199","url":null,"abstract":"<p><strong>Background: </strong>Prostaglandins and other uterotonics are first-line medical management for retained products of conception (RPOC), with transcervical surgery reserved for failed conservative management. In the rare setting of invasive retained products of conception (iRPOC), however, these approaches may not achieve complete evacuation. This study assessed laparoscopic resection as a fertility-preserving treatment for iRPOC.</p><p><strong>Methods: </strong>This case series included all eligible patients who underwent laparoscopic resection for iRPOC at a single tertiary centre between January 2012 and June 2024. Effectiveness was defined as complete resection on intra-operative transvaginal ultrasound scan (TVUS), no requirement for re-intervention, and no evidence of residual RPOC on follow-up TVUS 4-6 weeks post-operatively. Safety and post-operative fertility were evaluated as secondary outcomes.</p><p><strong>Results: </strong>Sixteen patients with iRPOC were included, with a mean age of 34.9 years and a mean follow-up of 61 months. Eight cases followed miscarriage or termination of pregnancy, and eight followed birth. Ultrasound-guided laparoscopic resection with uterine reconstruction was successful in all cases. Mean operative time, blood loss, and hospital stay were 69.6 min, 271.9 mL, and 1.9 days, respectively. Three patients attempting pregnancy subsequently conceived uneventfully.</p><p><strong>Conclusions: </strong>Laparoscopic management of iRCOP seems to be a feasible, effective and safe management option.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"1-9"},"PeriodicalIF":2.0,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initial experience with limited gastric resection and nodal basin lymphadenectomy guided by fluorescence for early gastric cancer in a Western center.","authors":"Martina Bonafede, Andrea Celotti, Luca Mattia Quarti, Luigi Totaro, Antonio Tarasconi, Giovanni Crotti, Nicolò Turco, Arianna Dendena, Ilaria Benzoni, Roberto Grassia, Gian Luca Baiocchi","doi":"10.1080/13645706.2026.2652467","DOIUrl":"https://doi.org/10.1080/13645706.2026.2652467","url":null,"abstract":"<p><strong>Background: </strong>With the increasing age of patients and the higher incidence of proximal gastric tumours, it is important to offer early gastric cancer (EGC) treatments that minimise post-operative morbidity and preserve quality of life. While several endoscopic and laparoscopic approaches have been established as standard treatments, total or subtotal gastrectomy with D2 lymphadenectomy remains the standard in Western countries, except for T1a lesions smaller than 2 cm. This study aims to explore the feasibility of stomach-preserving techniques combined with fluorescence-guided nodal basin harvesting in a Western setting for EGC.</p><p><strong>Methods: </strong>From July 2021 to November 2023, 12 patients (mean age 75, range 59-87) with cT1N0M0 gastric cancer underwent sentinel nodal basin harvesting after peritumoral injection of indocyanine green (ICG). Stomach-preserving surgery was performed in all patients: intraoperative endoscopic resection in two cases, stapler resection in four, and partial gastrectomy <i>via</i> gastrotomy in six cases. Lymphatic basins were dissected according to tumour location, and fluorescent nodes were separately analysed. Follow-up included CT scans and upper gastrointestinal (GI) endoscopy every six months for two years.</p><p><strong>Results: </strong>A total of 151 nodes were harvested (mean 12 per patient, range 5-22). Eleven cases were staged pT1N0; one 82-year-old patient with severe schizophrenia had pT3N2 disease, for which a completion total gastrectomy was suggested but declined. One patient experienced a Clavien-Dindo grade II complication. Mean hospitalisation was four days. After a median follow-up of 21.9 months (range 8-36), no recurrence was observed. Mapping confirmed that all metastases remained within the sentinel basin.</p><p><strong>Conclusions: </strong>Fluorescence-guided nodal basin harvesting combined with limited gastric resection is technically feasible in a Western context and does not compromise short-term oncological outcomes. Patient selection, meticulous staging, and consideration of possible secondary surgery are essential. Long-term oncological safety requires further investigation.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"1-7"},"PeriodicalIF":2.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147609237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reflected-wire technique for internal carotid artery catheterisation via the left radial approach in cerebral angiography.","authors":"Sheth Rishabh Hitendra, Vikas Bhatia, Ajay Kumar, Navneet Singla, Rajeev Chauhan","doi":"10.1080/13645706.2026.2628675","DOIUrl":"10.1080/13645706.2026.2628675","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to evaluate factors causing difficulty in internal carotid artery (ICA) access using the left transradial approach for diagnostic cerebral angiography.</p><p><strong>Methods: </strong>This was a prospective, single-centre, analytical study (n = 32 enrolled, n = 31 analysed) with an indication for diagnostic cerebral angiography. Diagnostic angiography via left transradial access was performed in all cases. Factors influencing the bilateral ICA catheterisation were evaluated.</p><p><strong>Results: </strong>Diagnostic angiography was successfully completed in all 31 analysed patients (100%). Successful RICA catheterisation was observed in 25 (80.6%) cases, and LICA catheterisation was observed in 77.43% (24/31) of cases. Reflecting the hydrophilic guidewire off the aortic root/valve to gain support and advance the catheter into the ICA was required in 17/24 (70.8%) of LICA and 9/25 (36%) of RICA cases to facilitate catheterisation. Positive correlation was observed between BCA-LCCA, left CCA-left subclavian artery angles and inability to cannulate LICA. A Type III arch was associated with an increased LICA cannulation time. The presence of a bovine aortic arch necessitated the use of the reflected-wire technique to cannulate the LICA.</p><p><strong>Conclusions: </strong>The reflected-wire technique can be used to facilitate ICA catheterisation via the left radial approach.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"125-134"},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146150260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}