Axillary Artery Access for Neuroendovascular Procedures in Infants: Where to Go When Femoral Puncture Fails?

The femoral artery approach is the primary neuroendovascular access in pediatric patients. However, alternative access sites are sometimes essential. We present the first report of axillary arterial access for neuroendovascular intervention in an infant, and a literature review on pediatric access routes. We present a case of a neonate diagnosed with vein of Galen malformation, with failed canulation of the femoral artery. A right axillary artery access was successfully employed for the intervention. The patient showed improvement and no complications. We demonstrate the feasibility of axillary artery access for neuroendovascular intervention, which may be an alternative for similar challenging cases.