Innovative Closure of an Iatrogenic Arteriovenous Radial Fistula Via the Distal Radial "Snuffbox" Access.

BACKGROUND

Iatrogenic radial arteriovenous fistula (AVF) is a rare but serious complication of transradial interventions, with no standardized management approach.

CASE SUMMARY

We report a case of iatrogenic radial AVF after a complex transradial percutaneous coronary intervention (PCI). Five months after PCI, the patient presented with right forearm swelling. Clinical examination revealed an audible bruit, suggestive for an AVF, which was confirmed by duplex ultrasound. The AVF was successfully treated by means of distal radial artery access (dTRA) via the "snuffbox" approach and deployment of a coronary stent-graft.

DISCUSSION

Management of radial AVFs remains nonstandardized, ranging from conservative strategies to surgical and endovascular interventions. To our knowledge, this is the first case using a coronary graft-stent via dTRA for radial AVF closure, introducing a novel treatment option.

TAKE-HOME MESSAGE: This case highlights dTRA as a viable approach for iatrogenic radial AVF repair. Familiarity with this technique may enhance interventionalists' ability to manage such complications effectively.