• technique

This month’s JNIS features further validation of the safety and efficacy of the transradial approach in the endovascular treatment of cerebrovascular disease.1 Building on their previous work, also published in the JNIS, Brunet and coauthors report their experience in diagnostic cerebral angiography employing the snuffbox approach.2 3 Although transradial techniques have gained popularity in the peripheral and cardiac interventional communities, they have not been embraced historically by neurointerventionalists. This has changed. Patient comfort, physician experience, and dramatically lower complication rates than transfemoral catheterization have precipitated a major shift toward transradial approaches among neurointerventional surgeons.

The snuffbox approach has several advantages over standard transradial catheterization. By entering the deep palmar branch of the artery, this distal approach lessens the likelihood of injury to the superficial palmar branch, which originates more proximally along the course of the radial artery and forms an important anastomosis with the ulnar artery.1 Furthermore, given the trajectory of the distal radial artery, the patient’s arm can be placed in an ergonomically natural position with the palm facing the hip. This facilitates the operator’s access to the puncture site and reduces …