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Related Concept Videos

Assessment of radial pulse01:11

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The radial pulse, located at the wrist, is often the preferred site for assessing peripheral pulse because of its accessibility and dependability. The process of determining the radial pulse involves several steps:
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The human body's intricate network of arteries ensures that every organ system receives the necessary oxygen and nutrients for optimal function. The arterial network in the head and neck region is particularly complex, providing vital blood flow to the brain, eyes, and other critical structures. Prominent arteries in this region include the internal carotid arteries and the vertebral arteries.
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Navigating radial artery loops in neurointerventions.

Evan Luther1, Joshua Burks2, Isaac Josh Abecassis2,3

  • 1Department of Neurological Surgery, University of Miami School of Medicine, Miami, Florida, USA evan.luther@jhsmiami.org.

Journal of Neurointerventional Surgery
|January 14, 2021
PubMed
Summary

Transradial access (TRA) in neuroendovascular procedures can fail due to radial loops, especially in older patients or those with small arteries. However, loops are not absolute contraindications, and a management protocol is suggested.

Keywords:
aneurysmangiographyinterventionnavigationtechnique

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Area of Science:

  • Neuroendovascular interventions
  • Vascular access techniques

Background:

  • Transradial access (TRA) offers lower complication rates than transfemoral approaches in neurointerventions.
  • Anatomic radial artery variants, such as radial loops, can impede navigation and lead to access site conversion.

Purpose of the Study:

  • To identify predictors of transradial access failure in neuroendovascular patients with radial loops.
  • To propose a management protocol for radial loop anomalies during TRA.

Main Methods:

  • Prospective review of 32 transradial neurointerventions with identified radial loops (July 2018-September 2020).
  • Evaluation of patient demographics and procedural characteristics to determine TRA failure predictors and successful loop management factors.

Main Results:

  • TRA failure occurred in 40.6% of cases, more frequently in patients over 60 years and those with recurrent radial artery diameter ≤2 mm.
  • Successful TRA was achieved in 19 patients, with 63.2% of these procedures utilizing the recurrent radial artery.

Conclusions:

  • Radial loops are associated with high TRA failure rates but are not absolute contraindications.
  • A management protocol for loop navigation is recommended, considering patient age, vascular tortuosity, and recurrent radial artery size for potential conversion.