Evaluation of repeat distal transradial access in the anatomic snuffbox

Area of Science:

• Vascular Access
• Interventional Radiology
• Arterial Cannulation

Background:

• The distal radial artery in the anatomic snuffbox is an emerging arterial access point.
• Its durability for repeated access across multiple procedures is not well-established.
• Evaluating the feasibility of repeated left-sided distal transradial access (ldTRA) is crucial.

Purpose of the Study:

• To assess the success rates of repeated left-sided distal transradial access (ldTRA) in the anatomic snuffbox.
• To determine the durability of this arterial access point for subsequent procedures.

Main Methods:

• A retrospective study evaluated patients undergoing radioembolization from January 2019 to May 2020.
• ldTRA was performed by 15 operators, with specific exclusion criteria applied.
• Barbeau patterns, arterial sizes, and success rates for first, second, and third ldTRA were compared.

Main Results:

• 93 ldTRA procedures were performed on 44 patients (up to three attempts per patient).
• Success rates were consistently high: 93% for the first, 95% for the second, and 100% for the third ldTRA.
• No significant changes in Barbeau patterns or artery size were observed between repeated accesses. Asymptomatic occlusion rate was 4.1% with successful subsequent access.

Conclusions:

• Success rates for ldTRA are indistinguishable across first, second, and third attempts.
• This suggests the distal radial artery in the anatomic snuffbox is a durable arterial access point.
• ldTRA demonstrates reliability for repeated interventions without significant complications.