Distal Radial Artery Access in the Anatomical Snuffbox for Neurointerventions: Case Report

World Neurosurg. 2019 Feb;122:355-359. doi: 10.1016/j.wneu.2018.11.030. Epub 2018 Nov 14.


Background: The distal transradial approach (dTRA) is being widely adopted by interventional cardiologists, primarily owing to reduced morbidity and mortality from access site complications. The distal radial artery has advantages over standard radial access in relation to procedural positioning and radial artery preservation, particularly in patients who may require multiple angiograms. One disadvantage is the smaller diameter of the artery with more challenging puncture of a smaller, weaker artery. We demonstrate the feasibility of dTRA in 2 patients who underwent successful diagnostic angiography and mechanical thrombectomy.

Case description: Two patients underwent dTRA for neurointerventions. In patient 1, a 5-F Glidesheath Slender and a Sim2 catheter were used for a 6-vessel cerebral angiogram. In patient 2, an 0.88-inch sheathless guide catheter was used to perform a mechanical thrombectomy. Successful hemostasis in both cases was achieved with a Safeguard Radial Compression Device; no complications were observed.

Conclusions: Neurovascular access via dTRA is feasible, and further exploration is warranted.

Keywords: Access; Distal radial; Endovascular; Neurointerventional; Stroke.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Angiography
  • Catheters*
  • Endovascular Procedures / methods*
  • Humans
  • Mechanical Thrombolysis / methods*
  • Middle Aged
  • Neurosurgical Procedures
  • Radial Artery / surgery*
  • Stroke / diagnostic imaging
  • Stroke / surgery*
  • Wrist