Aims and objectives
Transradial access (TRA) offers many benefits compared to transfemoral access (TFA) such as a lower rate of bleeding complications,shorter time to hemostasis (1),
immediate ambulation (2),greater post-procedure patient comfort (3)and lower costs (4).As opposed to the Transfemoral approach,
the TRA allows patients to freely flex their leve,
to walk and sit and it didn’t constrain absolute post-procedural bed rest (2).The most frequent complication of TRA is the radial artery spasm.
This is the main cause of conversion from radialapproach to femoral approach (5).TheTRA can be...
Methods and materials
From March 2017 to September 2017,
at the Department of Radiology “ARNAS" Garibaldi Hospital inCatania,
TRAwas performed in 11 patients (8female,
3 male; aged from 41 to 84years).Procedures include 4 abdominal bleedings,
one pelvic bleeding and 6 uterine artery embolisations (UAE) for fibroid treatment.
AE were performed in emergency,
UAE in programmed activity.To evaluate the feasibility of TRA,
a Barbeau test (8,
figure 1) and radial artery sonography were performed before the procedure.
In one case the presence of a type D waveform at Barbeau...
Technical success was obtained in all procedures.
No patient required crossover to TFA and only in one case TDA was performed(figure 2).
No major complications occurred,
apart from one case of minor complications: radial artery spasm.
After 24 hours artery’s patency was sufficient in all cases (figure 3).
TRA in AE procedures is safe and tolerated also in emergency.
Moreover access through deep palmar arch could represent an alternative technique in case of contraindication detected at Barbeau test.
due to the distal origin of deep palmar arch,
distal transradial approach will be an alternative vascular access without risk of complications involving the important vessels of the hand.
Jolly SS,MeerkinD,Joseph L.Comparison of transradial and femoral approaches for percutaneous coronary interventions: a systematic review and hierarchical Bayesian meta-analysis.AmHeartJ2012;163(4):632e48
Wilson KR,HawkenS,Wells GA,Ramirez FD,LeMayMR,So DY,GloverCA,FroeschlM,MarquisJF,LabinazM,Dick A,O'Brien ER.TransradialVersusTransfemoralArtery Approach for Coronary Angiography and percutaneous Coronary Intervention in the extremely obese.
J Am CollCariolIntv2012.
3.IezziRPompili M,Posa A,AnnicchiaricoE,GarcovichM,Merlino B,RodolfinoE,Di Noia V,Basso M,Cassano A,Barone C,GasbarriniA,Manfredi R,ColosimoC.TransradialversusTransfemoralAccess forHepaticChemoembolization:IntrapatientProspectiveSingle-CenterStudy.JVascIntervRadiol.Sep;28(9):1234-1239.
Patel RS,KlassD.TransradialAccess for Interventional Radiology: Single-Centre Proceduraland Clinical Outcome Analysis.CanAssocRadiolJ 2017