Safety and Feasibility of Transradial Access for Visceral Interventions in Patients with Thrombocytopenia

Titano, J.; Biederman, D.; Marinelli, Brett; Patel, Rahul; Kim, E.; Tabori, N.; Nowakowski, F.; Lookstein, R.; Fischman, A.

doi:10.1007/s00270-015-1264-3

Cited by 10 publications

(2 citation statements)

References 29 publications

(42 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, we propose a modified hemostasis protocol based on platelet counts and a patent hemostasis strategy for peripheral interventions. Platelet count was used to modify the strategy because: (1) bleeding complications were fewer in TRA, which was recommended for use in patients with a low platelet count (< 50×10 9 /L) in peripheral interventions; 23 , 24 (2) previous studies showed that antiplatelet therapy could increase the incidence of access-related adverse events (eg, hematomas); and (3) in this study, platelet count was found to be an independent predictor of whether or not patients could achieve complete hemostasis within 30 min after the TRA procedure. Additionally, to simplify the strategy, a platelet count of 100×10 9 /L was used as the cut-off value to stratify the patients into two groups.…”

Section: Discussionmentioning

confidence: 99%

Modified Patent Hemostasis Strategy Based on the Platelet Counts for Transradial Access Chemoembolization in Patients with Hepatocellular Carcinoma: A Prospective Single-Center Study

Luo¹,

Zhang²,

Tsauo³

et al. 2023

JHC

View full text Add to dashboard Cite

Objective This study aimed to investigate the shortest compression time to achieve hemostasis and the optimal hemostasis strategy in patients treated with transradial access chemoembolization (TRA-TACE). Methods From October 2019 to October 2021, 119 consecutive patients with hepatocellular carcinoma (HCC) who underwent 134 sessions of TRA-TACE were included in this prospective single-center study. The compression time was measured by decompressing the device for 30 min, and thereafter, every 10 min after the procedure until complete hemostasis was achieved. Results Technical success was achieved for all TRA procedures. None of the patients experienced major TRA-related adverse events. Minor adverse events occurred in 7.5% of the patients. The mean compression time was 31.8 ± 5.0 min. Factors that may impact hemostasis were analyzed by univariate and multivariate analyses, and a platelet count < 100×10 9 /L ( p = 0.016, odds ratio = 3.942) was found to be an independent factor that could predict the failure to achieve hemostasis within 30 min. For patients with a platelet count < 100×10 9 /L, the compression time required to achieve hemostasis was 60 min. For patients with a platelet count ≥ 100×10 9 /L, the compression time required to achieve hemostasis was 40 min. Conclusion To achieve hemostasis in patients with HCC treated with TRA-TACE, compression for 60 min is sufficient for those with a platelet count < 100×10 9 /L, and compression for 40 min is sufficient for those with a platelet count ≥ 100×10 9 /L.

show abstract

Section: Discussionmentioning

confidence: 99%

Modified Patent Hemostasis Strategy Based on the Platelet Counts for Transradial Access Chemoembolization in Patients with Hepatocellular Carcinoma: A Prospective Single-Center Study

Luo¹,

Zhang²,

Tsauo³

et al. 2023

JHC

View full text Add to dashboard Cite

show abstract

“…Only limited studies in the literature explored the use of trans radial access in hepatic trans arterial procedures. [11][12][13][14][18][19][20][21][22][23] Our study, by removing the operator bias, effectively compares the technical efficacy and safety of TRA, in patients undergoing hepatic tumor embolization, with TFA.…”

Section: Discussionmentioning

confidence: 99%

Retrospective Comparative Study to Assess the Safety and Efficacy of Transradial Arterial Access for Hepatic Tumor Embolizations: A Single Operator Experience

Sundareyan¹,

Karkhanis²

2022

The Arab Journal of Interventional Radiology

View full text Add to dashboard Cite

Objectives To assess the efficacy and safety of transradial arterial access (TRA) for hepatic tumor embolizations and compare the outcomes between the TRA and transfemoral arterial access (TFA) Materials and Methods A retrospective analysis of all consecutive hepatic tumor embolization procedures done through TFA or TRA by a single operator from November 2017 to April 2019 was performed. The procedural variables, including fluoroscopy time, radiation dose (reference air kerma [RAK]), conversion and complication rates, and patient preferences were recorded. The primary endpoint was technical success, which was defined as the successful completion of the embolization procedure. Procedural variables including radiation exposure and patient preferences, and complications were analyzed as secondary endpoints. Results Out of 102 procedures in 90 patients, 44 were performed through TFA and the rest by TRA. A technical success rate of 98.2% and a crossover rate of 1.7% were recorded for TRA. There were no major vascular complications and similar rates of minor complications (8.6% for TRA, 2.3% for TFA; P = 0.055), without any clinical sequelae. After the initial learning curve, no significant differences for other procedural variables were noted between the two access sites. Faster ambulation were achieved following TRA (P < 0.055). All 12 patients who underwent repeat TACE after initial TRA chose this again over TFA. Conclusions TRA is safe and effective for hepatic tumor embolization. Its safety and efficacy profile is comparable to that of TFA, with added improved patient comfort and faster ambulation. Advances in Knowledge New catheter options and modifications of the existing techniques as explained in this article proved radial arterial access as a safe and effective alternative in hepatic arterial embolization.

show abstract

Prophylactic platelet transfusions prior to surgery for people with a low platelet count

Estcourt

Malouf

Dorée

et al. 2018

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

Findings of this review were based on three small trials involving minor surgery in adults with thrombocytopenia. We found insufficient evidence to recommend the administration of preprocedure prophylactic platelet transfusions in this situation with a lack of evidence that transfusion resulted in a reduction in postoperative bleeding or all-cause mortality. The small number of trials meeting the inclusion criteria and the limitation in reported outcomes across the trials precluded meta-analysis for most outcomes. Further adequately powered trials, in people of all ages, of prophylactic platelet transfusions compared with no transfusion, other alternative treatments, and considering different platelet thresholds prior to planned and emergency surgical procedures are required. Future trials should include major surgery and report on bleeding, adverse effects, mortality (as a long-term outcome) after surgery, duration of hospital stay and quality of life measures.

show abstract

Safety and Feasibility of Transradial Access for Visceral Interventions in Patients with Thrombocytopenia

Abstract: Transradial visceral interventions in patients with thrombocytopenia are both feasible and safe, possibly without the need for platelet transfusions.

Cited by 10 publications

References 29 publications

Modified Patent Hemostasis Strategy Based on the Platelet Counts for Transradial Access Chemoembolization in Patients with Hepatocellular Carcinoma: A Prospective Single-Center Study

Modified Patent Hemostasis Strategy Based on the Platelet Counts for Transradial Access Chemoembolization in Patients with Hepatocellular Carcinoma: A Prospective Single-Center Study

Retrospective Comparative Study to Assess the Safety and Efficacy of Transradial Arterial Access for Hepatic Tumor Embolizations: A Single Operator Experience

Prophylactic platelet transfusions prior to surgery for people with a low platelet count

Contact Info

Product

Resources

About