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European Radiology

, Volume 29, Issue 1, pp 68–74 | Cite as

A reality check in transradial access: a single-centre comparison of transradial and transfemoral access for abdominal and peripheral intervention

  • Matthew L. Hung
  • Edward W. LeeEmail author
  • Justin P. McWilliams
  • Siddharth A. Padia
  • Pengxu Ding
  • Stephen T. Kee
Vascular-Interventional
  • 155 Downloads

Abstract

Objectives

The purpose of this study was to describe a single institution’s experience with transradial access (TRA) for angiographic interventions, and to compare technical success, complication rate and radiation dose of procedures performed with TRA to those performed with transfemoral access (TFA).

Methods

A retrospective cohort study of patients undergoing peripheral interventions via TRA or TFA from 2015 to 2017 was performed. The cohort comprised 33 patients undergoing 44 procedures via TRA and 37 patients undergoing 44 procedures via TFA. Outcome measures were technical success, access-related complications, fluoroscopy time and radiation exposure. Differences at p < 0.05 were considered to be statistically significant.

Results

Baseline characteristics were similar between patients who had procedures via TRA versus those who had procedures via TFA, including age, sex and body mass index. Technical success was achieved in 41/44 (93.2%) of procedures performed via TRA, compared to 44/44 (100%) of procedures performed via TFA (p = 0.241). There were three access-related complications (6.8%) when TRA was performed, compared to none when TFA was performed (p = 0.241). Fluoroscopy time was longer in procedures performed with TRA compared to those performed with TFA (27.3 vs 20.4, p = 0.033). Dose area product (DAP) did not differ with access site choice (p = 0.186).

Conclusions

TRA is a safe and feasible alternative to TFA for a range of peripheral interventions. However, TRA must be performed with prudence as it is not without complications and is technically challenging, leading to longer fluoroscopy time.

Key Points

Transradial access (TRA) is feasible in a variety of peripheral interventions, achieving success in 93.2% of cases.

Access-related complications are comparable between transfemoral access (TFA) and TRA (p = 0.241), but prudence must be taken during TRA as it could be technically challenging.

Procedures performed with TRA tend to have longer fluoroscopy time compared to those performed with TFA (p = 0.033), but the DAPs are comparable (p = 0.186).

Keywords

Radial artery access Femoral artery access Interventional radiology Embolisation Vascular access 

Abbreviations

DAP

Dose area product

PCI

Percutaneous coronary intervention

TACE

Transarterial chemoembolisation

TFA

Transfemoral access

TRA

Transradial access

Notes

Funding

The authors state that this work has not received any funding.

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Edward W. Lee, MD, PhD.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• retrospective

• case-control study

• performed at one institution

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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  1. 1.Division of Interventional Radiology, Department of RadiologyUCLA Medical Center, Ronald Reagan Medical Center at UCLA, David Geffen School of Medicine at UCLALos AngelesUSA

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