Background Trans-radial artery (TRA) access for neurointerventional procedures continues to garner increase usage among interventionalist. While TRA approaches are associated with a decreased risk of major access site complications, such issues can occur with a retained catheter, one of the most dreaded complications. Previously, the brachioradial artery (BR), specifically proximal BR, has been postulated to be associated with a retained catheter. Herein, the prevalence and predictors of BR in neurointerventional procedures is investigated in a large quaternary center. Methods

All patients who underwent a neurointerventional procedure during a 13-month period were retrospectively analyzed for a TRA approach and included in the study. Distal BR were defined as 10-20 cm proximal to the intercondylar line, with proximal BR defined as >20 cm. A multivariable logistic regression analysis was performed for predictor of a BR.

Results During the study period, 751 patients were found to meet inclusion criteria and analyzed. Of these patients, 51 (6.8%) had proximal or distal BR, of which 36 (4.8%) had proximal origins. On multivariate analysis, it was found that females (OR = 2.5 (95% CI: 1.1 - 6.1), p = 0.026) and Black patients (OR = 12.3 (95% CI: 2.0 - 62.4), p = 0.01) were more likely to have a proximal BR. Radial artery diameter was not a predictor for a BR. However, female patients were associated with smaller diameters (<0.27cm; OR 2.1 (95% CI 1.5-3.1), p <0.001).

Conclusion The brachioradial artery variant is found in nearly 7% of patients undergoing a neurointerventional procedures, with Black race and female gender found to be predictors of proximal BR origin. Thus, appropriate vigilance is required when treating these demographics for a neurointervention.

Disclosures J. Catapano: None. J. Rulney: None. A. Naik: None. S. Koester: None. V. Srinivasan: None. S. Desai: None. E. Winkler: None. A. Jadhav: None. A. Ducruet: None. F. Albuquerque: None. F. Albuquerque: None.