A reality check in transradial access: a single-centre comparison of transradial and transfemoral access for abdominal and peripheral intervention
- 155 Downloads
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).
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.
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).
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.
• 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).
KeywordsRadial artery access Femoral artery access Interventional radiology Embolisation Vascular access
Dose area product
Percutaneous coronary intervention
The authors state that this work has not received any funding.
Compliance with ethical standards
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.
Written informed consent was waived by the Institutional Review Board.
Institutional Review Board approval was obtained.
• case-control study
• performed at one institution
- 4.Romagnoli E, Biondi-Zoccai G, Sciahbasi A et al (2012) Radial versus femoral randomized investigation in ST-segment elevation acute coronary syndrome: the RIFLE-STEACS (Radial Versus Femoral Randomized Investigation in ST-Elevation Acute Coronary Syndrome) study. J Am Coll Cardiol 60:2481–2489CrossRefGoogle Scholar
- 6.Jin C, Li W, Qiao SB et al (2016) Costs and benefits associated with transradial versus transfemoral percutaneous coronary intervention in China. J Am Heart Assoc 5(4). https://doi.org/10.1161/JAHA.115.002684