Feasibility of Trans‐Radial Approach in Percutaneous Intervention for Upper Arm Dialysis Access

Abstract

Background: This retrospective study evaluated the feasibility and efficacy of trans-radial intervention for upper arm dialysis access. Methods: This study retrospectively reviewed 165 trans-radial interventions performed for upper arm dialysis access in 101 patients. Sixty-nine patients had arteriovenous graft (AVG), and 32 had arteriovenous fistula (AVF). Balloon angioplasty was performed in 66 stenotic dialysis accesses and 99 thrombosed dialysis accesses. Thrombosed dialysis access was further managed by additional balloon thrombectomy with or without urokinase injection. Results: Procedural time was 46.7 AE 25.5 minutes. Anatomic and clinical success rates were 89.7% and 84.2%, respectively. The rate of complications, most of which involved lesion rup-

Transradial approach for percutaneous intervention of malfunctioning arteriovenous accesses

“…Wu et al 10 documented a complication rate of 4% in their study of the TRA approach in occluded radiocephalic AVFs. Lin et al 8 reported a complication rate of 9.7% that included interventions for stenosis and thrombosis in AVFs/AVGs.…”

“…3,4 This approach has only recently been reported as an option to treat dysfunctional or thrombosed dialysis access in the upper arm. [5][6][7][8][9][10] In a traditional fistulogram with retrograde access, an additional angiography run with compression of the venous limb is required to visualize the anastomosis and arterial limb, which can add more time and radiation exposure to a procedure. There may be difficulty in clearly evaluating the juxta-anastomotic region and arterial limb during reflux of the venous limb in certain cases involving native fistulas with large emptying venous side branches that can dilute the contrast.…”

Retrograde transradial Approach for Hemodialysis Access Intervention: A Single-Center Study

“…Patients seen in the clinic underwent a clinical pulse examination; therefore, an arterial duplex to evaluate radial artery patency at post intervention was not routinely ordered. 19 In our study, complication rate was 4.1%. Wu et al documented a complication rate of 4% in their study of the TRA approach in occluded radiocephalic AVFs.…”

Kissing Balloon Technique Is a Useful Method for Angioplasty of the Radiocephalic Fistula Bifurcation Through a Percutaneous Trans-Radial Arterial Approach

“…The feasibility of trans‐radial intervention for forearm dialysis access has been reported recently 1,2 . This case suggests that for HD patients with radiocephalic AVF with bifurcation stenoses involving the arterial and venous anastomosis site, PTA using a kissing balloon technique through the percutaneous trans‐radial approach can be applied safely and efficiently.…”