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    Distal radial artery (snuffbox) access for carotid artery stenting - Technical pearls and procedural set-up

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    Authors
    Kuhn, Anna L.
    Singh, Jasmeet
    Moholkar, Viraj M.
    Satti, Sudhakar R.
    de Macedo Rodrigues, Katyucia
    Massari, Francesco
    Gounis, Matthew J.
    McGowen, Archie
    Puri, Ajit S.
    UMass Chan Affiliations
    Division of Neurointerventional Radiology, Department of Radiology
    Document Type
    Journal Article
    Publication Date
    2020-09-13
    Keywords
    Distal radial artery
    carotid artery stenting
    snuffbox
    stenosis
    transradial access
    Analytical, Diagnostic and Therapeutic Techniques and Equipment
    Cardiovascular Diseases
    Neurology
    Radiology
    
    Metadata
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    Link to Full Text
    https://doi.org/10.1177/1591019920959537
    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.
    Source

    Kühn AL, Singh J, Moholkar VM, Satti SR, Rodrigues KM, Massari F, Gounis MJ, McGowen A, Puri AS. Distal radial artery (snuffbox) access for carotid artery stenting - Technical pearls and procedural set-up. Interv Neuroradiol. 2020 Sep 13:1591019920959537. doi: 10.1177/1591019920959537. Epub ahead of print. PMID: 32924692. Link to article on publisher's site

    DOI
    10.1177/1591019920959537
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/48457
    PubMed ID
    32924692
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    ae974a485f413a2113503eed53cd6c53
    10.1177/1591019920959537
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