Transradial versus transfemoral arterial access in the uterine artery embolization of fibroids

Abstract

Purpose:Transradial arterial access has become more popular in body interventional procedures but has not been ubiquitously adapted. This retrospective study assesses the efficacy of this approach in uterine artery embolization. Aim of the study was to compare transradial to transfemoral arterial access in patients undergoing uterine artery embolization for the treatment of fibroids. Material and methods:A total of 172 patients underwent uterine artery embolization procedures at our institute from October 2014 to June 2020. Of these, 76 patients had their operations performed via transfemoral access while 96 underwent transradial access. The peak radiation dose, fluoroscopy time, procedure time, total contrast volume, and equipment cost for each procedure were all reviewed to evaluate for statistical differences between the 2 groups.Results: All cases were technically successful without major complications. The average peak skin dose was 2281 mGy, with no statistical difference between the transradial or transfemoral cohorts. Average fluoroscopy time was 25 minutes, also with no statistical difference between the subsets. Mean procedure time was 100 min, and mean contrast volume usage was 138 mL with no statistical differences. Similarly, the average equipment cost was $2204, with no significant differences found between transradial and transfemoral access. Conclusions:With respect to many pertinent radiation parameters, transradial access was evaluated as being an equally efficacious alternative to transfemoral access in uterine artery embolization procedures. The results of this study suggest that transradial access should be considered more often, whenever viable, as an option in the uterine artery embolization treatment of fibroids.

Use of transradial access to install two sequential stents for pseudoaneurysms along the celiac artery and common hepatic artery axes: A case report

“…Apart from the aforementioned bene ts (i.e. increased patient comfort or faster recovery times), TRA is also associated with a decreased rate of procedural complications when compared to TFA [1][2][3]. This is mostly attributable to the femoral artery being 3x larger in diameter than the radial artery, boding a higher risk for complications such as bleeding, pseudoaneurysm, or AV stula formation.…”

“…Transradial access (TRA) has gained signi cant popularity over the years in body interventional procedures. Many studies have reported on the bene ts of TRA over transfemoral access (TFA) [1][2][3].…”

“…These factors include increased patient comfort, reduced cost, faster postoperative turnaround, and a decreased rate of access site complications, among others [1][2][3]. Several disadvantages of TRA, when compared to TFA, include slightly higher radiation exposure and an increased rate of access failures [4][5].…”