Radial artery mechanical thrombectomy for transradial approach in neurointerventions: a step-by-step technical report

Radial artery occlusion (RAO) is a relatively common but benign complication following transradial endovascular approaches. Radial artery thrombectomy offers a potential strategy for re-access. Transradial access in the occluded vessel has been described as safe and feasible in recent literature; however, the step-by-step technical details have not been defined. This illustrative case highlights the technique developed at this institution, which has been performed in 7 consecutive patients. A middle-aged woman underwent initial diagnostic cerebral angiogram and balloon-occlusion test for tumor resection planning. Subsequently, the patient returned to for tumor embolization and was found to have RAO. Radial artery mechanical thrombectomy was performed, and this access was safely used for the embolization procedure.

This report provides a technical description with illustrations for this approach in the setting of an acute occlusion following prior radial artery catheterizations. Recanalization of an acutely occluded radial artery is feasible and safe in our institutional experience.