Radial Artery Cannulation at the Anatomical Snuffbox: Hype or Hope in Interventional Cardiology?

• Published in: Balkan medical journal Vol. 38; no. 4; pp. 251 - 252
• Main Authors: Taylan, Gökay, Öztürk, Cihan, Yalta, Kenan
• Format: Journal Article
• Language: English
• Published: Turkey Galenos Yayinevi Tic. Ltd 01.07.2021; Trakya Üniversitesi; Trakya University School of Medicine; Galenos Publishing House
• Subjects: Cardiology; Catheterization; Coronary Angiography; Humans; Letter to the Editor; Radial Artery - surgery; Tıp; Türkiye; Edirne
• ISSN: 2146-3123; 2146-3131; 2146-3131
• DOI: 10.5152/balkanmedj.2021.21025

To the Editor, A distal radial artery access site (namely, anatomical snuffbox) has been suggested as an alternative anatomical region for radial artery cannulation in patients undergoing coronary angiogram (CAG) or percutaneous coronary intervention (PCI).1-4 In their recently published article,1 Soydan et al. have demonstrated the potential feasibility of left anatomical snuffbox in the setting of primary PCI. We agree on the potential benefits of performing PCI through arterial cannulation at the anatomical snuffbox. However, we would like to make a few comments on their study findings1 and implications of this novel access site in the clinical setting: First, it may not be possible to draw firm conclusions regarding the absolute safety of this access site in female patients as they only constitute 13% of total study subjects (4 patients) in the current study.1 Similarly, female patients were also under-represented in previous studies evaluating anatomical snuffbox as a vascular access site in patients undergoing PCI.2,3 Importantly, female patients are well known to have a lower vascular caliber,4 more fragile tissue characteristics and a higher propensity for arterial spasm potentially leading to higher rates of complications during conventional radial artery cannulation. Difficulties might be relatively higher in female patients during arterial cannulation at the anatomical snuffbox due to the more delicate nature of this region.