Left Transradial Approach for Endovascular Management of a Posterior Circulation Aneurysm With Challenging Vascular Access

Objective: To investigate the clinical efficacy and safety of the left transradial approach for the interventional treatment of posterior circulation aneurysms (particularly suitable for cases with challenging conventional vascular access), and to summarize related technical experience along with a literature review, aiming to provide an alternative interventional strategy for endovascular treatment of aneurysms under difficult vascular access conditions. Methods: The clinical data of a patient with a posterior circulation aneurysm, who underwent interventional therapy via the left transradial approach due to anatomical difficulties with the conventional femoral artery access, were retrospectively analyzed. The procedural details were collected and documented, including the rationale for access selection, intraoperative challenges, and countermeasures, as well as the devices and materials used. Furthermore, a literature search was conducted to summarize the indications, technical feasibility, and key perioperative management points for this approach. Results: The posterior circulation aneurysm was successfully embolized via the left transradial approach in this case. Although challenges such as tortuous vasculature were encountered during the procedure, they were overcome by adjusting microcatheter and guidewire techniques, ultimately enabling the successful delivery of embolic materials to the aneurysm sac. Immediate postprocedural angiography confirmed complete aneurysm occlusion with preserved patency of the parent artery and no procedure-related complications. Conclusions: The left transradial approach for treating posterior circulation aneurysms in cases with difficult vascular access offers advantages such as convenience and improved patient comfort. It may be considered a preferred vascular access route for selected patients meeting the appropriate indications. However, strict attention to contraindications and thorough assessment of vascular anatomy and device deliverability are essential to ensure procedural safety and efficacy.