Endovascular Thrombectomy for Radial Artery Occlusion in Neuro-Interventional Procedures: A Report of Two Cases

Transradial access has garnered increasing popularity and acceptance among the neuro-interventional community. As this technique becomes commonplace for both diagnostic and interventional procedures, an understanding of potential complications and management is tantamount. Here, we describe two cases of thrombosed radial arteries successfully recanalized with traditional thrombectomy techniques. Two patients presented with aneurysmal subarachnoid hemorrhage and were found to have ruptured anterior communicating artery aneurysms. Both patients were deemed appropriate candidates for endovascular treatment. During attempted access, both patients were found to have occluded right radial arteries due to previous arterial access, one from a prior intervention and one from an arterial line placed at another facility. Thrombectomies were subsequently performed, one via manual aspiration through the access sheath and the other with a commercially available aspiration system. Both radial arteries were successfully recanalized and the interventions were completed via transradial access. Endovascular thrombectomy for radial artery thrombosis is a feasible and simple technique that can be employed to facilitate transradial access for neuro-endovascular procedures when a thrombosed radial artery is encountered. This technique can be attempted in cases of radial artery thrombosis prior to conversion to transfemoral access.