Radial Access Techniques

Evan Luther; Joshua Burks; David J McCarthy; Vaidya Govindarajan; Ahmed Nada; Vasu Saini; Aria Jamshidi; Hunter King; Rainya Heath; Michael Silva; Isaac Josh Abecassis; Robert M Starke

doi:10.1016/j.nec.2021.11.003

Radial Access Techniques

Neurosurg Clin N Am. 2022 Apr;33(2):149-159. doi: 10.1016/j.nec.2021.11.003. Epub 2022 Mar 2.

Authors

Affiliations

¹ Department of Neurological Surgery, University of Miami, Jackson Health System, Lois Pope Life Center, 2nd Floor, 1095 Northwest 14th Terrace, Miami, FL 33136, USA. Electronic address: evan.luther@jhsmiami.org.
² Department of Neurological Surgery, University of Miami, Jackson Health System, Lois Pope Life Center, 2nd Floor, 1095 Northwest 14th Terrace, Miami, FL 33136, USA.
³ Department of Neurological Surgery, University of Pittsburgh Medical Center, UPMC Presbyterian, Suite B-400, 200 Lothrop Street, Pittsburgh, PA 15213, USA.
⁴ Department of Neurological Surgery, University of Miami, Jackson Health System, Lois Pope Life Center, 2nd Floor, 1095 Northwest 14th Terrace, Miami, FL 33136, USA; Department of Neurological Surgery, Port Said University, Port Fouad City, Port Said, Governorate 42526, Egypt.
⁵ Department of Neurological Surgery, Drexel University College of Medicine, 2900 West Queen Lane, Philadelphia, PA 19129, USA.
⁶ Department of Neurological Surgery, University of Louisville, 220 Abraham Flexner Way, Louisville, KY 40202, USA.

PMID: 35346447
DOI: 10.1016/j.nec.2021.11.003

Abstract

Transradial access (TRA) has gained traction in neurointerventions as studies continue to demonstrate improved access site safety and equivalent end artery effectiveness when compared with traditional transfemoral techniques. Herein, we describe the technical nuances of obtaining TRA with a focus on distal TRA, left TRA, and sheathless TRA using larger bore catheters. We also discuss various strategies to avoid access site conversion if radial artery spasm or radial anomalies are encountered and offer some solutions for forming the Simmons catheter especially when it cannot be performed in the descending aorta. Lastly, we provide some insights regarding contraindications to TRA.

Keywords: Access site complications; Anatomic snuffbox; Distal transradial access; Long radial sheaths; Neuroendovascular; Radial artery anomalies; Radial artery spasm; Transradial access.

Publication types

Review

MeSH terms

Catheterization, Peripheral* / adverse effects
Catheterization, Peripheral* / methods
Humans
Radial Artery* / surgery
Treatment Outcome