Distal transradial access for targeted spinal angiography and embolization

Abstract

Background Spinal catheter angiography is commonly performed in the evaluation and treatment of spinal vascular lesions. The typical approach to spinal angiography consists of access through the femoral artery with the use of suitably shaped catheters for selective catheterization of the spinal segmental vasculature. The purpose of our study was to evaluate the safety and feasibility of distal transradial access through the “anatomical snuffbox” for targeted spinal angiography, for the investigation and treatment of selected spinal lesions Methods A retrospective review of patients who underwent transradial spinal angiography and embolization was performed from August 2019 to January 2022. A total of eight patients were identified, who underwent targeted spinal angiography through distal transradial access. Outcome measures were documented in a tabular manner. Results Radial access was successful in all patients. Seven patients had vascular tumors of the spinal column and underwent tumor embolization followed by segmental artery occlusion prior to surgery. One patient had a spinal dural AV fistula that could not be embolized due to feeding vessel tortuosity and eventually went on to have a laminectomy. Mean fluoroscopy time was 31.4 min. There were no access site hemorrhagic complications. One patient experienced transient mild hand numbness during the period of hemostasis with the vascular compression device that resolved completely within 24 h. Conclusions Distal transradial access is a feasible and safe option for targeted spinal angiography and treatment in selected patients.

Efficacy and Safety of Distal Radial Artery Approach for Coronary Angiography: A Retrospective Study

“…The technique of coronary intubation via distal radial artery approach is the key to the success of transradial coronary angiography [19]. During left coronary angiography, the super slippery guide wire was first inserted into the bottom of the aortic sinus so that the front end of the guide wire rolled up along the lateral wall of the left coronary sinus, and then the angiography catheter was pushed to the bottom of the sinus [20]. The technique included making the catheter head end naturally towards the left lateral wall of the ascending aorta, then withdrawing the guide wire, determining the opening position of the left coronary artery under fluoroscopy, and slowly pushing, lifting, and the slightly rotating the catheter head end into the left coronary artery opening [21].…”