Embolization of a chest wall arterial venous malformation using a transradial approach

We report the case of an 18-year-old male with a peripheral arteriovenous malformation (AVM) of the chest wall treated with embolization using a transradial approach CTRA). Chest wall AVMs are exceedingly rare, with very few case reports published. Treatment options are varied and include monitoring, surgical resection, and endovascular embolization. While less invasive, endovascular management can be complicated by the ability to both identify and cannulate arterial "feeder" vessels. Compared to a transfemoral approach, a TRA has been shown to reduce access-site complications and bleeding. However, technical factors such as differences in patient-specific vascular anatomy and catheter length required for intervention can also weigh heavily in access-site determination. We report on the usefulness of TRA in embolization of a chest wall AVM with inferior coursing, intercostal "feeder" arteries forming obtuse angles with the descending thoracic aorta, more readily cannulated by a superior TRA.