Background: Distal transradial access in the anatomical snuffbox has advantages over standard access in terms of patient and operator comfort levels and risk of ischemia. Radial artery preservation could be a relevant issue in patients requiring multiple radial artery procedures and coronary bypass with the use of a radial graft. One relevant drawback is the challenging puncture of a small and weak artery, with a steeper learning curve.
Aim: The study was aimed at proving feasibility and safety of right and left transradial access in the anatomical snuffbox.
Methods: All 52 consecutive patients assigned to only one operator program underwent diagnostic or procedural intervention through distal transradial access in the anatomical snuffbox.
Results: The overall feasibility was 90%, greater than expected in our early clinical experience, with 47 successful accesses out of 52 patients. Failures were due to proximal radial artery occlusion and hypoplastic/vasospastic distal radial artery.
Conclusion: Distal transradial access in the anatomical snuffbox is an appealing and feasible option for both patients and operators. Further studies are needed to evaluate the clinical benefits conferred by this approach.
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CVIR Endovasc
January 2025
Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.
Background: Hepatic artery infusion pump (HAIP) chemotherapy is a locoregional treatment for intrahepatic malignancies. HAIPs are surgically implanted, and the catheter tip is typically inserted into a ligated gastroduodenal artery stump. Potential complications at the catheter insertion site include dehiscence, pseudoaneurysm or extravasation, and adjacent hepatic arterial stenosis and thrombosis.
View Article and Find Full Text PDFActa Cardiol
January 2025
Department of Cardiovascular Medicine, Yale University School of Medicine, New Haven, CT, USA.
Background: Trans-radial coronary angiogram (TR-CAG) has gained popularity due to lower complication rates compared to transfemoral access. Operators can use either conventional catheters, such as Judkins, or single dedicated catheters, such as Tiger-II. This meta-analysis compared the safety and efficacy of Tiger-II versus Judkins catheters in TR-CAG.
View Article and Find Full Text PDFJ Neurointerv Surg
January 2025
Radiology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Background: We aim to share our experience of transradial access (TRA) for cerebral angiography and intervention in five patients ranging from 6 days to 7 months of age.
Methods: In this institutional review board-approved, retrospective case series, we reviewed all patients who underwent TRA for cerebral angiography with and without intervention. We describe three techniques for radial artery cannulation, namely: (1) bareback; (2) with a micropuncture sheath; and (3) with an intravenous catheter.
Acta Cardiol Sin
January 2025
Department of Internal Medicine, Division of Cardiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Aims: This study aims to verify the feasibility and safety of percutaneous coronary intervention (PCI) after a distal transradial approach (dTRA) with radial artery occlusion (RAO) recanalization.
Methods: Between July 2018 and January 2022, 30 patients underwent PCI following attempted RAO recanalization via dTRA. Among these cases, the target radial arteries could not be recanalized in five patients, necessitating alternative vascular access.
Prog Cardiovasc Dis
January 2025
Charles R Drew University School of Medicine, Los Angeles, CA, United States of America; VA Long Beach Healthcare System, Long Beach, CA, United States of America. Electronic address:
Vascular access for coronary, peripheral, and structural interventions has changed significantly over the past two decades. The evolving demand for both large-bore access for valvular interventions and mechanical support devices, and for safer access for coronary interventions, in patients with comorbidities have driven progress in these areas. This review will provide an overview of the techniques of arterial access in the femoral, forearm (radial and ulnar), and alternative (transcarotid, transaxillary, and transcaval) locations based on the latest evidence and experience.
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