Recent advances support using neuroendovascular treatments for a wide variety of cerebrovascular diseases ranging from mechanical thrombectomy to treatment of cerebral vascular malformations. Transradial access (TRA) has risen in popularity and is reported to be superior to transfemoral access (TFA) as it is associated with shorter hospital stays, lower costs, less morbidity and mortality, and increased patient satisfaction. However, TRA is associated with potential complications, namely radial artery spasm (RAS), radial artery occlusion (RAO), pseudoaneurysm, extravasation, arteriovenous fistula, and hematoma. Here we report a less commonly anticipated complication, radial artery avulsion.

TRA is associated with lower peri-procedural risks/complications. Increased understanding means we can now more accurately identify, treat, and prevent such outcomes. Commonly reported procedural modifications include switching to smaller diameter catheters, sheathless approach/using a guiding sheath, and pharmacological intervention including infiltrating the perivascular soft tissue with lidocaine and nitroglycerin. Such measures could potentially help to reduce the risk of vasospasm, vascular occlusion, and subsequent radial artery avulsion.