Department of Neurological Surgery, University of Miami School of Medicine, Miami, Florida, USA
Department of Neurological Surgery, University of Miami School of Medicine, Miami, Florida, USA.
J Neurointerv Surg. 2022 Jan;14(1). doi: 10.1136/neurintsurg-2021-017665.rep. Epub 2021 Oct 14.
Transradial access has become increasingly used in neurointerventions because it reduces access site complications. However, radial artery anomalies can be difficult to navigate, often necessitating conversion to femoral access. We describe the case of a female patient in her early 70 s who underwent preoperative embolization of a carotid body tumor via right transradial access. Her radial angiogram demonstrated the presence of a radial artery loop which was successfully navigated with a triaxial system but would not spontaneously reduce even after the guide catheter was advanced into the subclavian artery. However, manual manipulation of the catheters in the antecubital fossa under direct fluoroscopic visualization reduced the loop allowing the procedure to continue transradially. Although a majority of radial loops can be traversed and reduced using standard techniques, this case demonstrates that manual reduction can be successful when other measures fail. We recommend attempting this method before converting the access site.
经桡动脉入路在神经介入中应用日益增多，因为它可以减少入路部位并发症。然而，桡动脉异常可能难以处理，通常需要转为股动脉入路。我们描述了一位 70 岁出头的女性患者，她通过右侧经桡动脉入路进行颈动脉体瘤术前栓塞。她的桡动脉造影显示存在桡动脉环，使用三轴系统成功地进行了导航，但即使在导引导管推进至锁骨下动脉后，桡动脉环也不会自行缩小。然而，在直接透视下对肘前窝中的导管进行手动操作可减小环，从而允许继续经桡动脉入路进行操作。尽管大多数桡动脉环可以通过标准技术进行穿越和缩小，但本例表明，当其他措施失败时，手动复位可以成功。我们建议在转换入路部位之前尝试这种方法。
