• Joseph Haynes, Erez Nossek, Maksim Shapiro, Bree Chancellor, Anthony Frempong-Boadu, Simone Peschillo, Hunter Alves, Omar Tanweer, David Gordon, and Eytan Raz.
• University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.
• World Neurosurg. 2020 May 1; 137: e358-e365.

BackgroundVerification of complete occlusion or resection of neurovascular lesions is often performed using intraoperative angiography. Surgery for spinal vascular lesions such as arteriovenous malformations (AVMs) and arteriovenous fistulas (AVFs) is typically performed with the patient in the prone position, making intraoperative angiography difficult. No standardized protocol is available for intraoperative angiography during spinal surgery with the patient in the prone position. We have described our experience using radial artery access for intraoperative angiography in thoracic spinal neurovascular procedures performed with the patient in the prone position.MethodsWe reviewed the data from all patients who had undergone surgical resection of spinal vascular lesions in the prone position with radial artery vascular access for intraoperative angiography. The patients were treated in a hybrid endovascular operating room.ResultsA total of 4 patients were treated in the prone position using transradial artery access intraoperative angiography for confirmation of complete resection of the vascular lesions. Of the 4 patients, 2 had undergone surgery for a dural AVF, 1 for a pial AVF, and 1 for an AVM of the filum terminale. None of the patients had experienced any procedural complications.ConclusionRadial artery access for intraoperative angiography during spinal neurovascular procedures in which selective catheterization of a thoracic branch is necessary is feasible, safe, and practical.Copyright © 2020 Elsevier Inc. All rights reserved.

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