Republished: Manual reduction of a radial artery loop under direct fluoroscopic visualization

Area of Science:

• Interventional Neurology
• Vascular Access Techniques

Background:

• Transradial access is favored in neurointerventions due to lower access site complications compared to transfemoral approaches.
• Anatomical variations, such as radial artery loops, can complicate transradial procedures and may necessitate conversion to femoral access.

Observation:

• A case report details a patient in her 70s undergoing transradial embolization of a carotid body tumor.
• A significant radial artery loop was identified during the procedure, initially navigated with a triaxial system but resistant to spontaneous reduction.

Findings:

• Manual manipulation of catheters in the antecubital fossa under fluoroscopic guidance successfully reduced the radial artery loop.
• This technique allowed the neurointervention to be completed successfully via the transradial route without conversion to femoral access.

Implications:

• This case highlights manual catheter manipulation as an effective strategy for managing challenging radial artery loops during transradial neurointerventions.
• It suggests attempting manual reduction before resorting to conversion to femoral access, potentially improving procedural efficiency and patient outcomes.