Diagnostic Cerebral Angiography Through Distal Transradial Access: Early Experience with a Promising Access Route.

Abstract

Over the last few years, there has been considerable interest in the neurointervention community to use transradial approach for diagnostic and therapeutic neurointerventions. Distal radial approach has been postulated as an effective technique with reduced risk of hand ischemia. Our objective was to assess the safety and feasibility of distal transradial access (DTRA) to perform diagnostic cerebral angiography. A retrospective evaluation of 25 patients who were taken for DTRA through the anatomical snuff box from December 2021 to March 2022 was done. Twenty-five diagnostic cerebral angiographies were attempted with DTRA in 25 patients (age, 23-70 years; mean age, 45.4 years; 10 (40%) females). The right distal radial artery mean diameter was 2.09 mm. The procedure was successful in 21 (84%) procedures. Failure was seen in four cases, with three being converted to the proximal transradial approach without any need for redraping and one was converted to the transfemoral approach. The reason for access conversion was a severe spasm in three cases and dissection in one case. Selective catheterization of the cranial vessels through a distal transradial approach was achieved in 92 (96.8%) of 95 vessels. No significant access site complications were seen in the study cohort. DTRA is a promising approach for diagnostic cerebral angiography. Interventionists should get accustomed to this approach by overcoming the initial learning curve.