PT  - JOURNAL ARTICLE
AU  - Rimal Dossani
AU  - Muhammad Waqas
AU  - Michael K Tso
AU  - Gary B Rajah
AU  - David E Smolar
AU  - Jason M Davies
TI  - Navigating a proximal loop in the radial artery and avoiding the recurrent radial artery
AID  - 10.1136/neurintsurg-2019-015712
DP  - 2020 Jul 01
TA  - Journal of NeuroInterventional Surgery
PG  - 724--724
VI  - 12
IP  - 7
4099  - http://jnis.bmj.com/content/12/7/724.short
4100  - http://jnis.bmj.com/content/12/7/724.full
SO  - J NeuroIntervent Surg2020 Jul 01; 12
AB  - Several anatomical variations of the radial artery have been described in the literature. Common variations include radial artery loop, recurrent branch, and anastomotic channels connecting the radial and brachial arteries. These variations can pose significant technical challenges to safe radial artery catheterization. Because radial access for neurointervention is becoming popular, appreciation of these variations and mastery of techniques for safe radial artery catheterization are of paramount importance. In this operative video,(video 1) we present a case of a 75-year-old man who underwent middle meningeal artery embolization for treatment of chronic subdural hematoma using a transradial approach. The patient was found to have a radial artery loop and a recurrent branch off the radial artery. The loop could not be negotiated with the conventional technique. We therefore used a microcatheter system with a stiff microwire to navigate and straighten the radial loop under road map guidance. The remaining procedure was performed successfully.