Radial Arterial Access for Thoracic Intraoperative Spinal Angiography in the Prone Position

ABSTRACT Background Verification of complete occlusion or resection of neurovascular lesions is often done with intraoperative angiography. Surgery for spinal vascular lesions such as arteriovenous malformations (AVMs) and arteriovenous fistulas (AVFs) is typically performed in the prone position making intraoperative angiography difficult. There is no standardized protocol for intraoperative angiography in spinal surgeries performed in the prone position. Objective We describe our experience with using radial artery access for intraoperative angiography in thoracic spinal neurovascular procedures performed with patients in the prone position. Methods We reviewed all patients who underwent surgical resection of spinal vascular lesions in the prone position with radial artery vascular access for intraoperative angiography. Patients were treated in a hybrid endovascular operating room. Results 4 patients were treated in the pone position utilizing transradial artery access intraoperative angiography for confirmation of complete resection of the vascular lesions. 2 patients were operated for dural AVFs, one patient had a pial AVF, and one patient had an AVM of the filum terminale. None of the patients faced any procedural complications. Conclusion Radial artery access for intraoperative angiography in spinal neurovascular procedures in which selective catheterization of a thoracic branch is necessary, is feasible, safe, and practical.