Update on Transradial Access for Percutaneous Transcatheter Visceral Artery Embolization

Chu, Hee Ho; Kim, Jong Woo; Shin, Ji Hoon; Cho, Soo Buem

doi:10.3348/kjr.2020.0209

Cited by 9 publications

(12 citation statements)

References 61 publications

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“…This study demonstrated that the technical and clinical outcomes following RAE via TRA were similar to those of RAE via TFA for the management of iatrogenic renal hemorrhage, with no access site complications, similar fluoroscopy times, and similar radiation exposure. Although embolization itself is not dependent on the route of access, TRA may have several advantages, including patient comfort and a low rate of access site complications, especially in patients with obesity or coagulopathy [5,14]. The demographic characteristics, underlying diseases, and comorbidities of patients in the TRA and TFA groups did not differ significantly.…”

Section: Discussionmentioning

confidence: 94%

“…The cohort for this study consisted of 43 consecutive patients who underwent RAE for iatrogenic renal hemorrhage via TRA or TFA at Asan Medical Center, a tertiary medical center in Seoul, Korea, between October 2018 and December 2020. Because of the risk of hand ischemia, Barbeau type D waveform was regarded as a contraindication for TRA in patients with radial obstructive complications secondary to poor ulnar compensation [5]. The minimal radial artery diameter for study inclusion was 1.6 mm.…”

Section: Patientsmentioning

confidence: 99%

“…The number of transradial access (TRA) procedures has increased in patients undergoing visceral interventions, as TRA was found to enhance safety in patients with coagulopathy, as well as to result in early ambulation and discharge [4][5][6][7]. TRA was shown to be a feasible and safe alternative to TFA for renal interventions [8,9].…”

Section: Introductionmentioning

confidence: 99%

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Comparison of transradial and transfemoral access for transcatheter arterial embolization of iatrogenic renal hemorrhage

Cao

Kim

et al. 2021

PLoS ONE

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Background There are few reports of renal artery embolization (RAE) via transradial access (TRA) for renal hemorrhage, and none have compared outcomes of RAE via TRA and transfemoral access (TFA). The objective was to compare technical and clinical outcomes in patients undergoing RAE via TRA or TFA for iatrogenic renal hemorrhage. Materials and methods This study included 45 RAE procedures (16 TRA and 29 TFA) for iatrogenic renal hemorrhage in 43 patients performed at a tertiary referral center between October 2018 and December 2020. Information regarding underlying diseases, coagulation status, angiographic and embolization procedure details, technical and clinical successes, and complications were retrospectively evaluated. Results There were no differences in demographics, underlying diseases, updated Charlson comorbidity scores, angiographic findings, and volume of contrast material between the TRA and TFA groups. By contrast, prothrombin time and international normalized ratio were significantly lower in the TRA than in the TFA group. Embolic materials differed significantly in the two groups. Procedure duration, fluoroscopy time, digital subtraction angiography number, and dose area product were slightly lower in the TRA than in the TFA group, but the differences were not statistically significant. Technical and clinical success rates in the TRA and TFA groups were 100% and 96.6%, and 100% and 96.6%, respectively. No patient in either group experienced procedure-related complications during a 4 week follow-up period. Conclusion RAE via TRA in the management of iatrogenic renal hemorrhage was safe and feasible, with similar procedure duration and radiation exposure to RAE via TFA. TRA may be an acceptable alternative to TFA in these patients.

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Section: Discussionmentioning

confidence: 94%

Section: Patientsmentioning

confidence: 99%

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Comparison of transradial and transfemoral access for transcatheter arterial embolization of iatrogenic renal hemorrhage

Cao

Kim

et al. 2021

PLoS ONE

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“…Previous studies have demonstrated the advantages of TRA in terms of patient comfort and safety [ 6 13 14 ]. Many interventions can be safely performed via TRA, even in coagulopathies [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…Transradial artery access (TRA) for percutaneous intervention is known to have fewer complications at the access site, allows early ambulation and hospital discharge, improves patient satisfaction, and offers potential cost savings compared to transfemoral artery access (TFA) [ 4 5 ]. Furthermore, PAE via TRA can provide more advantages for the patient population, because it allows for leg elevation during a potentially long procedure to alleviate lower back pain and early ambulation to help urination, which may be made more difficult by prostate swelling caused by the procedure [ 6 ]. These benefits enable the treatment of patients on an outpatient basis.…”

Section: Introductionmentioning

confidence: 99%

Prostatic Artery Embolization for Lower Urinary Tract Symptoms via Transradial Versus Transfemoral Artery Access: Single-Center Technical Outcomes

et al. 2022

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Objective To evaluate the safety and feasibility of prostatic artery embolization (PAE) via transradial access (TRA) compared with transfemoral access (TFA). Materials and Methods This retrospective study included 53 consecutive men with lower urinary tract symptoms (LUTS) who underwent PAE between September 2018 and September 2021. Thirty-one patients (mean age ± standard deviation: 70.6 ± 8.4 years) were treated with TFA, including 14 patients treated before adopting TRA. Since December 2019, TRA has also been attempted with the procedure’s selection criteria of patent carpal circulation and a height ≤ 172 cm, with 22 patients treated via TRA (69.1 ± 9.6 years). Parameters of technical success (defined as successful bilateral embolization), clinical success (defined as LUTS improvement), procedural time, radiation dose, and adverse events were compared between the two groups using the Fisher’s exact test, independent sample t test, Wilcoxon signed-rank test, or Mann-Whitney test. Results All patients received at least one-side PAE. Technical success of PAE was achieved in most patients (TRA, 21/22; TFA, 30/31; p > 0.999). No technical problem-related conversion from TRA to TFA occurred. The clinical success rate was 85% (11/13) in patients with TRA, and 89% (16/18) in patients with TFA for follow-up > 2 weeks post-PAE (median, 3 months) ( p > 0.999). The median procedure time was similar in both groups (TRA, 81 minutes vs. TFA, 94 minutes; p = 0.570). No significant dose differences were found between the TRA and TFA groups in the dose-area product (median Gycm 2 , 95 [range, 44–255] for TRA and 84 [34–255] for TFA; p = 0.678) or cumulative air kerma (median mGy, 609 [236–1584] for TRA and 634 [217–1594] for TFA; p = 0.551). No major adverse events occurred in either of the groups. Conclusion PAE via TRA is a safe and feasible method comparable to conventional TFA. It can be safely implemented by selecting patients with patent carpal circulation and adequate height.

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Analysis of the Effectiveness of Transradial Access Puncture in the Application of Complications and Comfort after Cerebral Angiography

Wan

Gao

Huang

2022

Emergency Medicine International

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Objective. To investigate the analysis of the effectiveness of transradial access puncture in the application of complications and comfort after cerebral angiography. Methods. Retrospectively analyzed 80 patients who met the inclusion and exclusion criteria and were randomly divided into the control group (femoral artery group n = 40) and test group (radial artery group n = 40) using a random number table from January 2021 to January 2022 admitted to the department of neurology and department of vascular interventions in our hospital and compared the incidence of postoperative puncture site bleeding, time to first postoperative urination, and incidence of postoperative urinary retention and postoperative changes in comfort level. Results. There was 1 case of postoperative puncture site bleeding in the test group and 6 cases of postoperative puncture site bleeding in the control group, with statistically significant differences ( P < 0.05); the time to first urination in the test group (62.47) was significantly better than that in the control group (85.97), with statistically significant differences ( P < 0.05); there were 0 cases of urinary retention in the test group and 6 cases in the control group, with statistically significant differences ( P < 0.05). The GCQ scores of patients in the test group were significantly higher than those in the control group, and the difference was statistically significant ( P < 0.05). Conclusion. Transradial access puncture has a good clinical effect and can effectively reduce the complication rate of patients, which is worth promoting.

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Update on Transradial Access for Percutaneous Transcatheter Visceral Artery Embolization

Cited by 9 publications

References 61 publications

Comparison of transradial and transfemoral access for transcatheter arterial embolization of iatrogenic renal hemorrhage

Comparison of transradial and transfemoral access for transcatheter arterial embolization of iatrogenic renal hemorrhage

Prostatic Artery Embolization for Lower Urinary Tract Symptoms via Transradial Versus Transfemoral Artery Access: Single-Center Technical Outcomes

Analysis of the Effectiveness of Transradial Access Puncture in the Application of Complications and Comfort after Cerebral Angiography

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