Transradial versus Transfemoral Access for Hepatic Chemoembolization: Intrapatient Prospective Single-Center Study

Iezzi, Roberto; Pompili, Maurizio; Posa, Alessandro; Annicchiarico, Eleonora Brigida; Garcovich, Matteo; Merlino, Biagio; Rodolfino, Elena; Noia, Vincenzo Di; Basso, Michele A.; Cassano, Alessandra; Barone, Carlo; Gasbarrini, Antonio; Manfredi, Riccardo

doi:10.1016/j.jvir.2017.06.022

Cited by 46 publications

(50 citation statements)

References 21 publications

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“…Upper extremity and tibiopedal arterial access provide significant patient and operator benefits during percutaneous angiography and intervention. Transpedal access has been increasingly utilized in lower extremity revascularization during treatment of femoral-popliteal and tibioperoneal disease [10,11], and advantages of radial artery access for percutaneous coronary and peripheral intervention are well described [1][2][3][4][5][6][7][8][9]. Both access methods facilitate reduction in access site complications and time to patient ambulation; refined protocols for achieving hemostasis at these access sites may enable further improvement in patient safety and comfort to meet increasing demand for arterial access through these approaches.…”

Section: Discussionmentioning

confidence: 99%

“…The benefits of radial artery access relative to common femoral artery access are well studied: decreased bleeding and vascular complications, increased patient comfort and satisfaction, decreased time to hemostasis, and in the setting of percutaneous coronary intervention for ST-elevation myocardial infarction, significantly lower mortality [1][2][3][4]. Radial access is also used during noncoronary interventions [5], also showing improved patient satisfaction [6][7][8][9]. Retrograde tibiopedal access offers several mechanical advantages in the setting of lower extremity revascularization and may allow for successful endovascular treatment of tibioperoneal and femoropopliteal disease when antegrade-only techniques have failed [10,11].…”

Section: Introductionmentioning

confidence: 99%

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Nonfemoral Arterial Hemostasis Following Percutaneous Intervention Using a Focused Compression Device

Barrette

Vance

Shamimi-Noori

et al. 2020

Cardiovasc Intervent Radiol

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Purpose Upper extremity and tibiopedal arterial access are increasingly used during endovascular therapies. Balloon compression hemostasis devices in these anatomic locations have been described, but most utilize a compression surface extending well beyond the puncture site. We report single-center experience with an arterial puncture-focused compression device following upper extremity and tibiopedal access. Patients and Methods A series of 249 focused compression hemostasis devices (VasoStat, Forge Medical, Bethlehem, Pennsylvania, USA) were used in 209 patients following lower extremity (n = 63) and upper extremity (n = 186; radial: 90%) arterial access procedures using 4-7 French sheaths. Demographic, operative, and follow-up data were collected. Logistic regression was used to evaluate potential association between patient/operative variables and time to hemostasis. Results Primary hemostasis was achieved in 97.2% (242/ 249) following sheath removal; in 7 cases (2.8%) puncture site oozing occurred after initial device removal and required reapplication. Secondary hemostasis was 100% (249/249). Seven complications (2.8%) were recorded: 5 minor hematomas (2%) and 2 transient access artery occlusions (0.8%). Mean time to hemostasis enabling device removal was 55 ± 28 min. Elevated body mass index (BMI) was not associated with increased time to hemostasis (p = 0.31). Accessed artery, sheath size, and heparin dose were also not associated with time to hemostasis (p = 0.64; p = 0.74; p = 0.75, respectively). Conclusions The focused compression hemostasis device enabled rapid hemostasis with a low complication rate. Time to hemostasis was independent of BMI, access site, sheath size, or heparin dose.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Nonfemoral Arterial Hemostasis Following Percutaneous Intervention Using a Focused Compression Device

Barrette

Vance

Shamimi-Noori

et al. 2020

Cardiovasc Intervent Radiol

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“…The technical and clinical success rates of TRA are generally comparable to those of TFA in the majority of procedures: transarterial embolization for hepatic malignancy (7,8,11,13), mesenteric arterial procedures (4), prostate artery embolization (20), or uterine fibroid embolization (10). Very recently, Nakhaei et al (10) compared the clinical and technical outcomes of TRA uterine artery embolization (UAE) with those of the TFA approach.…”

Section: Technical and Clinical Success Rates Of Tra Vs Tfamentioning

confidence: 99%

“…Most studies on TRA were based on cardiology and neurointerventional procedures, and studies of the use of TRA in body and peripheral interventions performed by interventional radiologists are relatively few (4,(7)(8)(9)(10)(11)(12)(13)(14)(15). In this review, we aimed to compare the difference between TRA and TFA, provide the detailed technique and clinical applications of TRA in percutaneous transcatheter visceral artery embolization, and discuss the management of complications.…”

Section: Introductionmentioning

confidence: 99%

Update on Transradial Access for Percutaneous Transcatheter Visceral Artery Embolization

et al. 2021

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Transfemoral access (TFA) is a widely used first-line approach for most peripheral vascular interventions. Since its introduction in cardiologic and neurointerventional procedures, several advantages of transradial access (TRA) over TFA have been demonstrated, such as patient preference, lower complication rates, early ambulation, and shorter hospital stay. However, studies reporting the safety and efficacy of this approach for peripheral vascular interventions performed by interventional radiologists are relatively few. This review aimed to summarize the technique and clinical applications of TRA in percutaneous transcatheter visceral artery embolization and the management of complications.

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“…This trend has been driven by several factors including the known reduced incidence of access site complications,4 reduced risk of major bleeding,5 reduced ICU and hospital length of stay,4 5 and reduced costs to national health systems 6. In addition to these practical and safety-based indications, radial artery access is more comfortable and better tolerated by patients due to the distance of the artery from adjacent nerves as well as the ability to mobilize earlier post-procedure 7–9…”

Section: Introductionmentioning

confidence: 99%

Procedural success with radial access for carotid artery stenting: systematic review and meta-analysis

Jaroenngarmsamer

Bhatia

Kortman

et al. 2019

J NeuroIntervent Surg

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BackgroundFemoral access is the traditional approach for endovascular carotid artery stenting. Radial access is increasingly used as an alternative approach due to its known anatomical advantages in patients with unfavorable aortic arch morphology via the femoral approach and its excellent access site safety profile. Our objective was to analyze procedural success using radial access for carotid artery stenting as reported in the literature.MethodsThree online databases were systematically searched following PRISMA guidelines for studies (n ≥20) using radial artery access for carotid artery stenting (1999–2018). Random-effects meta-analysis was used to pool the procedural success (successful stent placement with no requirement for crossover to femoral access), mortality, and complication rates associated with radial access.ResultsSeven eligible studies reported procedural success outcomes with a pooled meta-analysis rate of 90.8% (657/723; 95% CI 86.7% to 94.2%; I2=53.1%). Asymptomatic radial artery occlusion occurred in 5.9% (95% CI 4.1% to 8.0%; I2=0%) and forearm hematoma in 1.4% (95% CI 0.4% to 2.9%; I2=0%). Risk of minor stroke/transient ischemic attack was 1.9% (95% CI 0.6% to 3.8%; I2=42.3%) and major stroke was 1.0% (95% CI 0.4% to 1.8%; I2=0%). There were three deaths across the seven studies (0.6%; 95% CI 0.2% to 1.3%; I2=0%). The meta-analysis was limited by statistically significant heterogeneity for the primary outcome of procedural success.ConclusionRadial access for carotid artery stenting has a high procedural success rate with low rates of mortality, access site complications, and cerebrovascular complications. The potential benefits of this approach in patients with unfavorable aortic arch access should be explored in a prospective randomized trial.

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Transradial versus Transfemoral Access for Hepatic Chemoembolization: Intrapatient Prospective Single-Center Study

Cited by 46 publications

References 21 publications

Nonfemoral Arterial Hemostasis Following Percutaneous Intervention Using a Focused Compression Device

Nonfemoral Arterial Hemostasis Following Percutaneous Intervention Using a Focused Compression Device

Update on Transradial Access for Percutaneous Transcatheter Visceral Artery Embolization

Procedural success with radial access for carotid artery stenting: systematic review and meta-analysis

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