TY - JOUR T1 - Distal transradial access in the anatomical snuffbox for diagnostic cerebral angiography JF - Journal of NeuroInterventional Surgery JO - J NeuroIntervent Surg SP - 710 LP - 713 DO - 10.1136/neurintsurg-2019-014718 VL - 11 IS - 7 AU - Marie-Christine Brunet AU - Stephanie H Chen AU - Samir Sur AU - David J McCarthy AU - Brian Snelling AU - Dileep R Yavagal AU - Robert M Starke AU - Eric C Peterson Y1 - 2019/07/01 UR - http://jnis.bmj.com/content/11/7/710.abstract N2 - Background The transradial approach for endovascular angiography and interventional procedures is superior to the traditional transfemoral approach in several metrics, including lower access-site complication rates, higher patient satisfaction, and lower hospital costs. Interventional cardiologists have begun to adopt the distal transradial approach (dTRA) for coronary interventions as it has an improved safety profile and improved procedural ergonomics. Adaptation of dTRA for neuroendovascular procedures promises similar benefit, but requires a learning curve.Objective To report the first use of dTRA for diagnostic cerebral angiography and demonstrate the feasibility and safety of a dTRA.Methods A retrospective review of our prospective institutional database of consecutive cases of cerebral DSA performed via dTRA between August 2018 and December 2018 was performed. Patient demographics, procedural and radiographic metrics, and clinical data were recorded.Results 85 patients were identified with an average age of 53.8 years (range 18–82); 67 (78.8%) patients were female. 78 patients underwent successful dTRA diagnostic cerebral angiography, with a mean of five vessels catheterized and average fluoroscopy time of 12.0 min, or 2.6 min for each vessel. Seven patients required conversion to transfemoral access, with the most common reason being inability to advance the wire and radial artery spasm. There were no complications.Conclusion dTRA is associated with decreased rates of radial artery occlusion, ischemic hand events, as well as improved patient comfort, faster periprocedural management, and cost benefits. Our preliminary experience with dTRA for diagnostic cerebral angiography demonstrates excellent feasibility and safety in combination with relative efficiency. ER -