Journal: Brain Circulation
Article Title: Snuff box radial access: A technical note on distal radial access for neuroendovascular procedures
doi: 10.4103/bc.bc_2_19
Figure Lengend Snippet: Distal radial “snuff box” access technique: (a) The ultrasound probe is positioned in a coronal section of the distal radial artery (white arrow), keep in mind that the vessel is on the top of the scaphoid and runs lateral and up at roughly 20° before reaching the back of the hand from the ventral wrist location. (b) The distal radial artery is seen within the snuff box (white arrow), the scaphoid bone is noted with a white star beneath. (c) Once the micropuncture needle returns brisk arterial blood (note the medial and inferior direction of the needle in the snuff box, white arrow), (d) we can verify intraluminal placement of the needle on ultrasound (white arrow). (e) A 4- or 5-French transitional dilator is placed allowing a 38 Bentson guide wire for sheath or guide placement. (f) A radial cocktail of heparin, 100-μg nitroglycerine, and 2.5–5 mg of verapamil is given slowly through the transitional dilator. (g) The 038 Bentson wire is placed through the dilator (white arrow) and the dilator removed. (h) Finally, the sheath or long guide is placed and attached to flush (note the arm is at the patient's side and the sheath facing the surgeon). (i) Good distal runoff (white arrow) and proximal arterial patency (white star) are noted on the distal radial artery run
Article Snippet: Next, a 0.038 inch Bentson wire (Cook Medical) is utilized and the 4–6-French short sheath is placed [ ].
Techniques: