Low brachial artery access is a safe alternative approach for the interventionalist when the femoral artery approach is not feasible or desirable. One important advantage of upper extremity access is the favorable route of entry from above into the caudally oriented visceral arteries. Although the risk of complications is low for experienced operators, meticulous attention to technique and knowledge of local anatomy are imperative to safely use brachial artery access. Adequate anticoagulation with heparin and use of lowest-profile devices may minimize complications. Following these procedures, patients must be carefully evaluated immediately and trained to self-monitor for up to 2 weeks for signs and symptoms of bleeding and nerve compression. This article describes the indications, procedural steps, expected outcomes, and tips on overcoming technical challenges of brachial artery access.
