Distal radial artery access among cases with radial artery occlusion for primary percutaneous intervention

Radial artery access is associated with lower bleeding risks and higher patient satisfactions compared with femoral access. It is currently the preferred access for coronary catheterization and interventions, and increasingly used for peripheral and cranial vascular interventions. Herein, we present a patient who had a recent procedures included right transradial right vertebral artery and peripheral vascular interventions. She was admitted for abdominal aortic bifemoral artery bypass, and was complicated with ST elevation myocardial infarction that required immediate cardiac catheterization. Patient did not have palpable radial access and ultrasonography confirmed a total occlusion of right radial artery with thrombus. Although distal right radial artery – at the anatomical snuff box – was not palpable, artery was patent and could be accessed successfully with ultrasonography guidance.