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<p>Fibromuscular dysplasia (FMD) affecting the arteries of the upper extremity is rare, and its implications for vascular access strategies in neurointerventional procedures remain unclear. We report two patients with brachial artery FMD identified before endovascular treatment of an unruptured intracranial aneurysm, which influenced the access planning. In both cases, brachial artery FMD was detected during diagnostic angiography. In case 1, although the affected segment was long, no apparent tortuosity or luminal narrowing was observed, so we carefully proceeded with the transradial approach for aneurysm treatment. In contrast, case 2 demonstrated a relatively short but markedly tortuous segment with focal stenosis, and the procedure was performed via the transfemoral approach. Both aneurysms were successfully treated without periprocedural complications. These cases suggest that lesion morphology, including vessel tortuosity and focal stenosis, may be relevant factors in access route selection in addition to lesion length.</p>

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Transradial approach in patients with brachial artery fibromuscular dysplasia: implications of lesion morphology for access route selection

  • 期刊论文

  • 发表日期：

    2026年6月18日

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  • Hideki Endo,
  • Tomoaki Ishizuka,
  • Masahiro Okuma,
  • Ryunosuke Yoshihara,
  • Tatsushi Hatayama,
  • Yasuyuki Tatsuta,
  • Koji Oka,
  • Hirohiko Nakamura

摘要

Fibromuscular dysplasia (FMD) affecting the arteries of the upper extremity is rare, and its implications for vascular access strategies in neurointerventional procedures remain unclear. We report two patients with brachial artery FMD identified before endovascular treatment of an unruptured intracranial aneurysm, which influenced the access planning. In both cases, brachial artery FMD was detected during diagnostic angiography. In case 1, although the affected segment was long, no apparent tortuosity or luminal narrowing was observed, so we carefully proceeded with the transradial approach for aneurysm treatment. In contrast, case 2 demonstrated a relatively short but markedly tortuous segment with focal stenosis, and the procedure was performed via the transfemoral approach. Both aneurysms were successfully treated without periprocedural complications. These cases suggest that lesion morphology, including vessel tortuosity and focal stenosis, may be relevant factors in access route selection in addition to lesion length.