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- Title
Distal radial artery (snuffbox) access for carotid artery stenting – Technical pearls and procedural set-up.
- Authors
Kühn, Anna Luisa; Singh, Jasmeet; Moholkar, Viraj M; Satti, Sudhakar R; Rodrigues, Katyucia de Macedo; Massari, Francesco; Gounis, Matthew J; McGowan, Archie; Puri, Ajit S
- Abstract
Purpose: To report use of distal radial artery (dRA) access for carotid artery stenting (CAS) and to discuss procedural setup and technical considerations for a successful intervention. Methods: A retrospective review of our prospective neurointerventional database of CAS was conducted between May 2019 and March 2020. All CAS cases via dRA in the anatomical snuffbox were identified. Patient demographics, clinical information, procedural and radiographic data was collected. Results: 22 CAS procedures in 20 patients via dRA were identified. Patients' mean age was 69.4 years (range 53–87 years). 3 patients were female. Mean radial artery diameter was 2.1 mm (range 1.6–2.8 mm). dRA access was achieved in all cases. Conversion to femoral access was required in 2 cases (9.1%) due to persistent radial artery vasospasm resulting in patient discomfort despite multiple additional doses of intraarterial vasodilators and added intravenous sedation as well as tortuous vessel anatomy and limited support of the catheters in a type 3 aortic arch for left CAS. Conclusion: Our preliminary experience with dRA access for CAS suggests this approach to be feasible and safe for patients. Technical considerations are important and preprocedural planning is necessary for a successful intervention. Catheter systems and devices specifically designed for radial access are needed to enable more interventionalists to safely perform neurointerventional procedures via wrist access.
- Subjects
RADIAL artery; CAROTID artery; THORACIC aorta; ARTERIAL puncture; WOMEN patients; ANATOMY
- Publication
Interventional Neuroradiology, 2021, Vol 27, Issue 2, p241
- ISSN
1591-0199
- Publication type
Article
- DOI
10.1177/1591019920959537