Snare Assisted Guiding Catheter Stabilization for Left Internal Carotid Artery Access via Right Distal Radial Approach

Transradial approach (TRA) is increasingly adopted in neurointervention. However, distal system advancement to the left internal carotid artery (ICA) via a right radial approach can be technically challenging, particularly when a small-caliber system is required. We report a case in which a stable guiding system was established via a right distal radial approach by capturing the guiding catheter with a snare and applying traction. Despite marked ICA tortuosity, distal advancement of the distal access catheter and system push during flow diverter deployment were successfully achieved. This single-case technical experience suggests that snare-assisted guiding catheter stabilization may represent one technical option for addressing support limitations in challenging TRA procedures.