Navigating a proximal loop in the radial artery and avoiding the recurrent radial artery

Dossani, Rimal H; Waqas, Muhammad; Tso, Michael K; Rajah, Gary; Smolar, David E.; Davies, Jason M

doi:10.1136/neurintsurg-2019-015712

Cited by 15 publications

(11 citation statements)

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“…One of the cases was previously reported. 2 The frequency of radial loop was thus 1%. Nine patients underwent diagnostic cerebral angiograms.…”

Section: Resultsmentioning

confidence: 93%

“…This technique has been described previously. 2 For diagnostic procedures, the same maneuvers were performed through an .047inch Sim2 diagnostic catheter.…”

Section: Technical Notementioning

confidence: 99%

“…Radial loops are associated with a high risk of procedural failure through radial access for cardiac and neuroangiographic procedures. [1][2][3][4] Radial loops are often associated with recurrent radial artery branches, which arise from the apex of the radial artery loop. Recognition of this anomalous pattern is important because inadvertent catheterization of the recurrent branch instead of the radial artery loop may result in severe spasm and consequent procedural failure from a radial artery approach.…”

Section: Introductionmentioning

confidence: 99%

“…[6][7][8] To the best of our knowledge, radial loop related to radial artery access for neuroangiographic procedures is limited to a single video technical report. 2 Therefore, we decided to share our experience and case series detailing the technical management of radial artery loops when encountered during transradial access.…”

Section: Introductionmentioning

confidence: 99%

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Endovascular management of radial artery loop for neuroangiography: Case series

et al. 2020

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Background Radial loops are rare congenital radial artery anomalies that may pose a significant challenge to successful transradial neuroangiography. In this case series, we describe the anatomy and frequency of radial artery loops and provide a technique for successful navigation of this anatomic anomaly. Methods We reviewed our database of radial diagnostic or interventional neuroangiographic procedures to identify cases in which a radial loop was encountered during the procedure. The loop pattern, the presence of an associated recurrent radial artery branch, navigation technique, and procedure-related complications were recorded. A descriptive analysis was performed. Results A total of 997 transradial approach procedures were performed over a 9-month period. A radial loop was identified in 10 (1.0%) patients. The average age was 68.6 ± 14.3 years. A microcatheter advanced over a microwire was used to navigate the loop and avoid entry into the recurrent branch. A diagnostic neuroangiographic procedure was performed successfully in 8 cases and an intervention was performed successfully in 1 case. A 360° loop was present in 2 of these cases. In each case, transradial access was performed successfully. In 1 other diagnostic case, transradial access was aborted, and the femoral artery was accessed to perform the procedure. Conclusions A radial loop was present in 1% of the cases in this series. Our technical results suggest that this anomaly should not be considered a contraindication to transradial neuroangiography because the procedure was successfully performed in most (9 of 10) cases using a microcatheter system to navigate the loop.

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“…One of the cases was previously reported. 2 The frequency of radial loop was thus 1%. Nine patients underwent diagnostic cerebral angiograms.…”

Section: Resultsmentioning

confidence: 93%

“…This technique has been described previously. 2 For diagnostic procedures, the same maneuvers were performed through an .047inch Sim2 diagnostic catheter.…”

Section: Technical Notementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Endovascular management of radial artery loop for neuroangiography: Case series

et al. 2020

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“… 27 The variant in which the recurrent radial artery does not arise from the RA, as presented in our case, could perhaps ease the trans-radial approach for endovascular neurointervention, which otherwise could impede success in cases in which a radial loop or recurrent radial artery exist. 28 …”

Section: Discussionmentioning

confidence: 99%

Upper limb arterial pattern: clinical correlation and embryological perspective

Sophia

Singh

et al. 2021

J. vasc. bras.

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Background Variations in the upper limb arterial pattern are commonplace and necessitate complete familiarity for successful surgical and interventional procedures. Variance in the vascular tree may involve any part of the axis artery of the upper limb, including the axillary artery and brachial artery or its branches, in the form of radial and ulnar arteries, which eventually supply the hand via anastomosing arches. Objectives To study the peculiarities of the arterial pattern of the upper limb and to correlate them with embryological development. Methods The entire arterial branching of forty-two upper limbs of formalin fixed adult human cadavers was examined during routine dissection for educational purposes, conducted over a 3-year period in the Department of Anatomy, Lady Hardinge Medical College, New Delhi. Results The study found: 1) One case in which a common trunk arose from the third part of the axillary artery, which immediately splayed into four branches (2.4%); 2) High division of the brachial artery into ulnar and radial arteries, in 3 cases (7.1%); 3) Pentafurcation of the brachial artery into ulnar, interosseus, radial, and radial recurrent arteries and a muscular twig to the brachioradialis in 1/42 cases (2.4%); 4) Incomplete Superficial Palmar arch in 3/42 cases (7.1%); and 5) Presence of a median artery in 2/42 case(4.8%) Conclusions This study observed and described the varied arterial patterns of the upper limb and identified the various anomalous patterns, supplementing the surgeon’s armamentarium in various surgical procedures, thereby helping to prevent complications or failures of reconstructive surgeries, bypass angiography, and many similar procedures.

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