Purpose: To report the use of a transradial approach to coil embolization of an intracranial aneurysm in a morbidly obese patient.
Technical note: When the transfemoral approach was inaccessible in a morbidly obese patient with a ruptured intracranial aneurysm, coil embolization was performed via a 6-F sheath placed in the radial artery. Multiple platinum coils were delivered to exclude the 14-mm basilar tip aneurysm. Because heparin was not reversed, the sheath was left in the artery for 24 hours then removed. The radial artery was pulsatile, and blood supply to the hand was good.
Conclusions: The radial artery appears to be a suitable route for access to the intracranial vessels when the femoral artery is not available.