What is the expected recovery after endovascular coiling of a cerebral aneurysm performed via a transradial (wrist) approach?

Recovery After Transradial Endovascular Coiling of Cerebral Aneurysms

Recovery from transradial (wrist) approach for aneurysm coiling is typically rapid, with most patients discharged the following day and experiencing minimal wrist discomfort without vascular complications.

Immediate Post-Procedure Recovery

The transradial approach offers distinct advantages over traditional femoral access for endovascular aneurysm treatment:

• Hospital discharge occurs within 24 hours in the vast majority of uncomplicated cases, with patients leaving the hospital the next day after the procedure 1, 2
• Wrist discomfort is minimal and represents the primary local complaint, without significant vascular complications at the access site 1
• No radial artery occlusion or spasm has been documented in published series of transradial cerebral aneurysm treatment 2
• Radial pulse remains palpable immediately after all interventions, confirming preserved arterial patency 2

Procedural Success and Safety Profile

The transradial approach demonstrates excellent technical outcomes:

• Average procedure duration is approximately 65 minutes, comparable to femoral access 2
• Successful treatment is achieved in essentially all cases (100% in reported series) without need for conversion to femoral access 1, 2, 3
• No approach-related complications have been reported in published case series, including no access site bleeding, hematoma formation, or arterial injury 1, 2, 3
• Same-day ambulation is possible immediately after the procedure, unlike femoral access which requires prolonged bed rest 2

Neurological Recovery Timeline

Your overall recovery depends primarily on whether the aneurysm was ruptured or unruptured, not the access site:

For Unruptured Aneurysms:

• Patients maintain their pre-procedure neurological status in the vast majority of cases, with the same modified Rankin Scale score at discharge 1
• Return to normal activities occurs within days to weeks, limited primarily by any neurological effects of the procedure itself rather than the wrist access site
• Permanent neurological complications occur in 2.6% of cases for endovascular coiling of unruptured aneurysms, with mortality of 0.9% 4

For Ruptured Aneurysms:

• Recovery is determined by the severity of the initial hemorrhage, not the access approach 4
• At 1 year, endovascular coiling results in 6.9% absolute risk reduction in death or disability compared to surgical clipping 4
• Seizure rates are substantially lower with endovascular treatment (relative risk 0.52) compared to surgery 4

Long-Term Considerations

Ongoing surveillance imaging is required because:

• Aneurysm retreatment is needed in 17.4% of coiled patients over long-term follow-up, which is 6.9 times higher than surgical clipping 4
• First follow-up imaging should occur at 6-12 months, then yearly or every 2 years once stability is documented 4
• Rebleeding risk for completely occluded coiled aneurysms is 0.11% annually, which is very low but requires continued monitoring 4

Specific Wrist Recovery Details

The radial access site itself heals rapidly:

• No special wrist immobilization is required beyond the immediate post-procedure compression period
• Normal wrist function returns within days, with only transient mild discomfort reported 1
• No long-term wrist complications have been documented in neuroendovascular series using transradial access 1, 2, 3

Common Pitfalls to Avoid

• Do not confuse access site recovery with overall neurological recovery—the wrist heals quickly regardless of the aneurysm treatment outcome
• Ensure appropriate follow-up imaging is scheduled before discharge, as incomplete aneurysm occlusion may require retreatment 4, 5
• Monitor for any delayed neurological symptoms in the weeks following treatment, as thromboembolic complications can occur despite successful coiling 4