Distal radial access in the anatomical snuffbox for neurointerventions: a feasibility, safety, and proof-of-concept study

UMMS Affiliation

Division of Interventional Neuroradiology, Department of Radiology

Publication Date


Document Type



Cardiovascular Diseases | Neurology | Radiology | Surgery


PURPOSE: To report the first use of distal radial artery (dRA) access for a variety of neurointerventions and to demonstrate the safety and feasibility of this approach.

METHODS: A retrospective review of our prospective neurointerventional database of endovascular interventions was conducted and, between May and October 2019, all patients in whom the intervention was performed via dRA in the anatomical snuffbox were identified. Patient demographics, clinical information, procedural and radiographic data were collected.

RESULTS: 48 patients with a mean age of 64.4 years (range 35-84 years) were included. 27 patients were female. dRA access was achieved in all cases. Conversion to femoral access was required in five cases (10.4%) due to tortuous vessel anatomy and limited support of the catheters in the aortic arch. Interventions performed included aneurysm treatment (with flow diverters, Woven EndoBridge device placement, coiling or stent-assisted coiling), arteriovenous malformation and dural arteriovenous fistula embolization, carotid artery stentings, stroke thrombectomy, thrombolysis for central retinal artery occlusion, intracranial stenting, middle meningeal artery embolization, vasospasm treatment, and spinal angiography with embolization. Radial artery vasospasm was seen in two cases and successfully treated with antispasmolytic medication. No symptomatic radial artery occlusion or ischemic event was observed.

CONCLUSION: dRA access is safe and effective for a variety of neurointerventions. Our preliminary experience with this approach is very promising and shows high patient satisfaction.


aneurysm, angiography, flow diverter, intervention

DOI of Published Version



Kühn AL, de Macedo Rodrigues K, Singh J, Massari F, Puri AS. Distal radial access in the anatomical snuffbox for neurointerventions: a feasibility, safety, and proof-of-concept study. J Neurointerv Surg. 2020 Jan 8;neurintsurg-2019-015604. doi: 10.1136/neurintsurg-2019-015604. [Epub ahead of print]. PMID: 31915209.

Journal/Book/Conference Title

Journal of Neurointerventional Surgery

Related Resources

Link to article in PubMed

PubMed ID