“Snuffbox” distal radial access

• Main Authors: Pua, Uei, Quek, Lawrence Han Hwee
• Other Authors: Lee Kong Chian School of Medicine (LKCMedicine)
• Format: Article
• Language: English
• Published: 2020
• Subjects: Science::Medicine; Snuffbox; Radial
• Online Access: https://hdl.handle.net/10356/142153
• Institution: Nanyang Technological University

A 68-year-old man with hepatocellular carcinoma underwent technetium-99m macroaggregated albumin angiography before yttrium-90 implantation. Using the “snuffbox” technique, the distal radial artery was accessed under ultrasound (US) guidance over the trapezium ( Fig 1 ). Adequate collateral circulation was confirmed with a Barbeau type A waveform. The access artery measured 2.1 mm in caliber, and a 5-F Glidesheath Slender (Terumo, Tokyo, Japan) was inserted via modified Seldinger technique ( Figs 1–3 ). Hemostasis was achieved with the use of a Safeguard pressure-assisted device (Merit Medical, South Jordan, Utah; Fig 4 ). The snuffbox radial artery access represents an alternative transradial access site that allows radial sheath insertion with the patient’s hand pronated. Besides being useful in patients with flexion contractures, it is also advantageous because it allows positioning of the left hand across the patient’s lower abdomen in a neutral position during transradial intervention, allowing patient positioning as for a routine right groin puncture.