• David J McCarthy, Stephanie H Chen, Marie-Christine Brunet, Sumedh Shah, Eric Peterson, and Robert M Starke.
• Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA. Electronic address: djm77@med.miami.edu.
• World Neurosurg. 2019 Feb 1; 122: 355-359.

BackgroundThe distal transradial approach (dTRA) is being widely adopted by interventional cardiologists, primarily owing to reduced morbidity and mortality from access site complications. The distal radial artery has advantages over standard radial access in relation to procedural positioning and radial artery preservation, particularly in patients who may require multiple angiograms. One disadvantage is the smaller diameter of the artery with more challenging puncture of a smaller, weaker artery. We demonstrate the feasibility of dTRA in 2 patients who underwent successful diagnostic angiography and mechanical thrombectomy.Case DescriptionTwo patients underwent dTRA for neurointerventions. In patient 1, a 5-F Glidesheath Slender and a Sim2 catheter were used for a 6-vessel cerebral angiogram. In patient 2, an 0.88-inch sheathless guide catheter was used to perform a mechanical thrombectomy. Successful hemostasis in both cases was achieved with a Safeguard Radial Compression Device; no complications were observed.ConclusionsNeurovascular access via dTRA is feasible, and further exploration is warranted.Copyright © 2018 Elsevier Inc. All rights reserved.

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