Percutaneous proximal axillary artery versus femoral artery access for endovascular interventions

Mordhorst, Alexa; Yan, Tyler D.; Hoskins, Nathan; Gagnon, Joel E.; Kazemi, Kamyar

doi:10.1016/j.jvs.2022.03.031

Cited by 7 publications

(16 citation statements)

References 23 publications

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“…No heterogeneity was observed between the studies. The incidence of MI was reported in two studies 19,20 . The risk of MI was significantly lower in the TFA group than in the UEA group [2.29% vs. 4.42%; RR:0.51; 95% CI:0.38–0.69; p < 0.0001; I2 = 0%] (Figure 2E).…”

Section: Resultsmentioning

confidence: 79%

“…Moderate heterogeneity was observed among studies. Five studies reported the risk for 30‐day mortality as an outcome 14,17,18,20,21 . The risk of 30‐day mortality was lower at 2.26% in the TFA group than at 2.68% in the UEA group, but this finding was not statistically significant [RR:0.83; 95% CI:0.48–1.41; p = 0.48; I2 = 0%] (Figure 2D).…”

Section: Resultsmentioning

confidence: 98%

“…High heterogeneity was detected among the studies, for which a leave‐one‐out sensitivity analysis by Knowles et al was performed, which reduced heterogeneity to 0%. Five studies reported the duration of hospital stay (in days) as an outcome 14,15,17,19,20 . The duration of hospital stay was shorter in the TFA group than in the UEA group; however, these findings were not statistically significant [SMD, −0.20; 95% CI: −0.53 to 0.12; p = 0.22; I2 = 77%] (Figure 2I).…”

Section: Resultsmentioning

confidence: 99%

“…were excluded. All studies [14][15][16][17][18][19][20][21] included reported fluoroscopy time as an outcome. Fluoroscopy time (in minutes) was significantly shorter in the TFA group than in the UEA group [SMD, −0.62; 95% CI: −1.00 to −0.24; p = 0.001; I2 = 97%] (Figure 2K).…”

Section: Secondary Endpointsmentioning

confidence: 99%

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Comparison between the outcomes of transfemoral access and transfemoral access with adjunct upper extremity access in patients undergoing endovascular aortic repair: A pilot systematic review and meta‐analysis

Goyal,

Fatima,

Mushtaq

et al. 2024

Cathet Cardio Intervent

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Endovascular aortic repair is an emerging novel intervention for the management of abdominal aortic aneurysms. It is crucial to compare the effectiveness of different access sites, such as transfemoral access (TFA) and upper extremity access (UEA). An electronic literature search was conducted using PubMed, EMBASE, and Google Scholar databases. The primary endpoint was the incidence of stroke/transient ischemic attack (TIA), while the secondary endpoints included technical success, access‐site complications, mortality, myocardial infarction (MI), spinal cord ischemia, among others. Forest plots were constructed for the pooled analysis of data using the random‐effects model in Review Manager, version 5.4. Statistical significance was set at p < 0.05. Our findings in 9403 study participants (6228 in the TFA group and 3175 in the UEA group) indicate that TFA is associated with a lower risk of stroke/TIA [RR: 0.55; 95% CI: 0.40–0.75; p = 0.0002], MI [RR: 0.51; 95% CI: 0.38–0.69; p < 0.0001], spinal cord ischemia [RR: 0.41; 95% CI: 0.32–0.53, p < 0.00001], and shortens fluoroscopy time [SMD: −0.62; 95% CI: −1.00 to −0.24; p = 0.001]. Moreover, TFA required less contrast agent [SMD: −0.33; 95% CI: −0.61 to −0.06; p = 0.02], contributing to its appeal. However, no significant differences emerged in technical success [p = 0.23], 30‐day mortality [p = 0.48], ICU stay duration [p = 0.09], or overall hospital stay length [p = 0.22]. Patients with TFA had a lower risk of stroke, MI, and spinal cord ischemia, shorter fluoroscopy time, and lower use of contrast agents. Future large‐scale randomized controlled trials are warranted to confirm and strengthen these findings.

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Section: Resultsmentioning

confidence: 79%

Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

Section: Secondary Endpointsmentioning

confidence: 99%

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Comparison between the outcomes of transfemoral access and transfemoral access with adjunct upper extremity access in patients undergoing endovascular aortic repair: A pilot systematic review and meta‐analysis

Goyal,

Fatima,

Mushtaq

et al. 2024

Cathet Cardio Intervent

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“…Percutaneous ultrasound-guided arterial access has been used in humans [ 12 , 13 , 14 , 15 , 16 , 17 ], dogs [ 18 ], and experimental pigs [ 19 ]. In horses, there is a report of a single case from decades ago [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Ultrasound-Guided Carotid Access and Puncture Closure with Angio-Seal in Horses

Vitoria

Laborda

Serrano‐Casorran

et al. 2022

Animals

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Background: There are different indications for endovascular surgery in horses, mainly the treatment of guttural pouch mycosis. Traditionally, these procedures are carried out by open arteriotomy of the common carotid artery (CCA), although less invasive percutaneous ultrasound-guided carotid access (PUGCA) has been described in experimental horses. In human medicine, commercial closure systems are used to seal these arterial puncture sites and reduce complications. The aims of this study are to retrospectively describe our experience with PUGCA in clinical cases and to report, for the first time, the use of the commercial vascular closure device Angio-Seal after PUGCA in horses. Methods: Retrospective study of clinical case records. Collected parameters, including the feasibility of the PUGCA and variables related to the safety and efficacy of the use of the Angio-Seal. Results: Twelve PUGCA procedures in 11 horses were included. In all cases, the artery was effectively accessed, and the planned procedure could be performed. In two cases, haematoma/bleeding due to incorrect use of the Angio-Seal was recorded. This complication rate (16.66%) was lower than that obtained in other studies using PUGCA in horses, but where the puncture was sealed by manual compression only. Main limitations: A control group of clinical cases with PUGCA but without using Angio-Seal is not available. Conclusions: Clinical data confirm previous experimental results, which showed that PUGCA is safe and effective in horses. The Angio-Seal system, regardless of possible complications due to incorrect use, can be used safely and effectively in horses. Further studies comparing arterial access site management using manual compression or Angio-Seal would be necessary to state if its routine use in horses is advisable.

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Multicentre International Registry of Open Surgical Versus Percutaneous Upper Extremity Access During Endovascular Aortic Procedures

Bertoglio

Oderich²,

Melloni³

et al. 2023

European Journal of Vascular and Endovascular Surgery

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Percutaneous proximal axillary artery versus femoral artery access for endovascular interventions

Cited by 7 publications

References 23 publications

Comparison between the outcomes of transfemoral access and transfemoral access with adjunct upper extremity access in patients undergoing endovascular aortic repair: A pilot systematic review and meta‐analysis

Comparison between the outcomes of transfemoral access and transfemoral access with adjunct upper extremity access in patients undergoing endovascular aortic repair: A pilot systematic review and meta‐analysis

Percutaneous Ultrasound-Guided Carotid Access and Puncture Closure with Angio-Seal in Horses

Multicentre International Registry of Open Surgical Versus Percutaneous Upper Extremity Access During Endovascular Aortic Procedures

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