Recanalization of the occluded radial artery via distal transradial access in the anatomic snuffbox

Abstract

Background Radial artery occlusion is a common complication after coronary angiography and percutaneous coronary intervention via the transradial access. In recent years, coronary angiography and percutaneous coronary intervention via the distal transradial access has gradually emerged, but recanalization of the occluded radial artery through the distal transradial access has rarely been reported. Case presentation A 67-year-old female with arterial hypertension and diabetes mellitus was admitted to the hospital due to chest pain for three hours. She was diagnosed with acute myocardial infarction. After admission, the patient successfully underwent emergency coronary angiography and percutaneous coronary intervention through the right transradial access. Radial artery occlusion was found after the operation, and recanalization was successfully performed through the right distal transradial access before discharge. Immediately after the operation and one month later, vascular ultrasonography showed that the antegrade flow was normal. Conclusions This report presents a case of radial artery occlusion after emergency coronary angiography and percutaneous coronary intervention in which recanalization was successfully performed through the right distal transradial access. This case demonstrates that recanalization of a radial artery occlusion via the distal transradial access is safe and feasible.

The anatomical snuffbox for transradial access in arteriovenous fistula intervention: Case report and brief review of the literature

“…The left-hand snuffbox approach is preferred because it uses the patient's nondominant hand (in most cases), and the operator can use the right hand to perform fine movements, such as in the femoral access. Besides, the operator's distance from the fluoroscope is safer [15] . If left-handed access is selected, the patient's arm can be placed over the body with the operator on the right side.…”

Distal Radial Artery Access for Recanalization of Radial Artery Occlusion and Repeat Intervention: A Single Center Experience

“…To our knowledge, only four previous reports tested the feasibility of RAO recanalization via DRA [ 12 , 13 , 14 , 15 ]. Gasparini et al described the same technique of balloonless dilatation and wiring directly through the needle [ 12 ].…”

“…With the adoption of DRA, attempts to recanalize recent or chronic RAO have also increased, with promising results, but reporting is limited to case reports or case series [ 12 , 13 , 14 , 15 ]. The conclusion of these publications called for larger registries to investigate the prevalence of complications of radial angioplasty (perforation, hematoma, digital ischemia, etc.)…”

“…The conclusion of these publications called for larger registries to investigate the prevalence of complications of radial angioplasty (perforation, hematoma, digital ischemia, etc.) [ 12 ] and its long-term patency [ 13 , 14 ], which is perhaps the most important aspect of the prospect of reintervention, especially since RAO is asymptomatic in most cases and recanalization performed exclusively for hand ischemia is less common [ 15 ]. The aim of this study was to explore the feasibility, safety, and long-term patency of the recanalization of chronic RAO and to present some technical procedural insights.…”

Retrograde recanalization of radial artery occlusion via the distal transradial artery: A single-center experience

“…In 2018, Sheikh et al (11) reported a successful angioplasty via dTRA in recanalizing the left RAO of a 75-year-old man with a medical history of coronary artery bypass, previous multiple PCIs, and severe peripheral vascular disease. Li et al (12) presented a case of RAO after emergency CAG and PCI in which recanalization was successfully performed through dTRA access. Additionally, case series have suggested that dTRA was safe and convenient for retrograde recanalization of RAO, with success rates of 88 to 93% (4,5).…”