Maulia Prismadani, Maulia and Ivana Purnama Dewi, Ivana and Louisa Fadjri Kusuma Wardhani, Louisa and Johanes Nugroho Eko Putranto, Johanes The anatomical snuffbox for transradial access in arteriovenous fistula intervention: Case report and brief review of the literature. Radiology Case Reports. ISSN 1930-0433

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Abstract

Abstract Left distal transradial artery (dTRA) access in the anatomical snuffbox is a relatively novel technique and is considered beneficial when left TRA access is required. This technique offers essential advantages, including improved patient comfort and lower vascular complications. dTRA may provide an entry site for retrograde recanalization of the radial artery. We presented a case of a 65-year-old man with 5-stage chronic kidney disease (CKD) and had left a radio-cephalic arteriovenous fistula (AVF) for routine hemodialysis. There was obstruction of AVF a month after creation. The vascular intervention has been performed using left dTRA access for retrograde recanalization. Angiogram showed cephalic vein obstruction and non-significant stenosis of the proximal radial artery. Percutaneous transluminal angioplasty was successful in improving cephalic vein flow. Hemostatic performed without a hemostatic device. This case report highlights the dTRA access approach in the anatomical snuffbox to recanalize AVF occlusion in the wrist in a patient with CKD.

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