Endovascular N-Butyl Cyanoacrylate Embolization for Recurrent Post-Traumatic Radial Arteriovenous Fistula After Failed Surgical Ligation: A Technical Note and Literature Review.

Radial arteriovenous fistulas (AVFs), although rare and usually trauma-related, are being observed more frequently due to the growing popularity of transradial catheterization. Treatment options include physical compression, surgical repair, or endovascular intervention. While surgical ligation remains the standard treatment for most extremity AVFs, treatment failure and recurrence have been reported. Endovascular embolization with N-butyl cyanoacrylate (NBCA) is well established in neurovascular and visceral interventions; however, its application in extremity AVFs has rarely been documented. We present a case of recurrent post-traumatic radial AVF successfully treated using NBCA as the sole embolic agent in a single session following failed surgical ligation. This case highlights a technically simple and cost-effective approach using microcatheter-based glue embolization and blood pressure cuff-assisted flow control. A brief literature review is also provided, comparing this technique with other endovascular treatment options, including stent graft placement and balloon-assisted glue embolization.