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Transradial flow diversion with an aberrant right subclavian artery
  1. Richard Bram,
  2. Gursant Atwal
  1. Neurosurgery, University of Illinois College of Medicine at Chicago, Chicago, Illinois, USA
  1. Correspondence to Dr Richard Bram, Neurosurgery, University of Illinois College of Medicine at Chicago, Chicago, IL 60612, USA; rbram3{at}


Transradial access for diagnostic and therapeutic neurointerventional procedures has gained popularity due to a decreased incidence of access site complications and improved patient comfort compared with transfemoral access.1–4 An aberrant right subclavian artery is an aortic arch variant characterized by a right subclavian artery that arises directly from the arch as the most distal great vessel. Transradial access with an aberrant right subclavian artery is anatomically challenging due to the predilection of the catheter system to collapse into the descending aorta. In this (video 1), we describe a step-by-step technique for transradial access in a patient with an aberrant right subclavian artery undergoing endovascular flow diversion for a left superior hypophyseal artery aneurysm. Particular emphasis is placed on the technique for accessing the proximal arch and aortic valve as well as distal catheter navigation while avoiding prolapse into the descending aorta.

Video 1
  • Aneurysm
  • Flow Diverter
  • Technique
  • Angiography

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  • Contributors The authors confirm contribution to the manuscript as follows: All authors assisted with conceptualization/design of the report and a formal analysis of the angiographic data. RB conducted an investigation of relevant literature and wrote the first draft of the manuscript with input from GA. RB edited the supplemental video. GA interpreted, critically reviewed, and edited the manuscript. GA provided oversight of the report. All authors approved the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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