PURPOSE: Transradial access (TRA) has been shown to lower morbidity and bleeding complications compared to transfemoral access in percutaneous coronary interventions. Morbid obesity, commonly defined as a body mass index (BMI) ≥40 kg/m2, has been shown to be a risk factor for access site complications irrespective of access site. This study evaluates the safety and feasibility of performing visceral endovascular interventions in morbidly obese patients via TRA. METHODS: Procedural details, technical success, and 30-day major and minor access site, bleeding, and neurological adverse events were prospectively recorded in a database of 1057 procedures performed via the radial artery. From this database we identified 22 visceral interventions performed with TRA in 17 morbidly obese patients (age: 53 ± 11 years, female: 71%) with a median BMI of 42.7 kg/m2. RESULTS: Interventions included radio-embolization (n = 7, 31.8%), chemo-embolization (n = 6, 27.3%), uterine fibroid embolization (n = 4, 18.2%), renal embolization (n = 2, 9.1%), hepatic embolization (n = 1, 4.5%), lumbar artery embolization (n = 1, 4.5%), and renal angioplasty (n = 1, 4.5%). The technical success was 100%. There were no major or minor adverse access site, bleeding, or neurological complications at 30 days. CONCLUSIONS: This study suggests visceral endovascular interventions performed in morbidly obese patients are safe and feasible.
PURPOSE: Transradial access (TRA) has been shown to lower morbidity and bleeding complications compared to transfemoral access in percutaneous coronary interventions. Morbid obesity, commonly defined as a body mass index (BMI) ≥40 kg/m2, has been shown to be a risk factor for access site complications irrespective of access site. This study evaluates the safety and feasibility of performing visceral endovascular interventions in morbidly obesepatients via TRA. METHODS: Procedural details, technical success, and 30-day major and minor access site, bleeding, and neurological adverse events were prospectively recorded in a database of 1057 procedures performed via the radial artery. From this database we identified 22 visceral interventions performed with TRA in 17 morbidly obesepatients (age: 53 ± 11 years, female: 71%) with a median BMI of 42.7 kg/m2. RESULTS: Interventions included radio-embolization (n = 7, 31.8%), chemo-embolization (n = 6, 27.3%), uterine fibroid embolization (n = 4, 18.2%), renal embolization (n = 2, 9.1%), hepatic embolization (n = 1, 4.5%), lumbar artery embolization (n = 1, 4.5%), and renal angioplasty (n = 1, 4.5%). The technical success was 100%. There were no major or minor adverse access site, bleeding, or neurological complications at 30 days. CONCLUSIONS: This study suggests visceral endovascular interventions performed in morbidly obesepatients are safe and feasible.
Authors: Clifford R Weiss; Godwin O Abiola; Aaron M Fischman; Lawrence J Cheskin; Jay Vairavamurthy; Brian P Holly; Olaguoke Akinwande; Franklin Nwoke; Kalyan Paudel; Stephen Belmustakov; Kelvin Hong; Rahul S Patel; Eun J Shin; Kimberley E Steele; Timothy H Moran; Richard E Thompson; Taylor Dunklin; Harvey Ziessman; Dara L Kraitchman; Aravind Arepally Journal: Radiology Date: 2019-04-02 Impact factor: 11.105
Authors: Rajiv N Srinivasa; Jeffrey Forris Beecham Chick; Joseph J Gemmete; Bill S Majdalany; Anthony Hage; Alex Jo; Ravi N Srinivasa Journal: Diagn Interv Radiol Date: 2018-09 Impact factor: 2.630
Authors: Louis-Xavier Barrette; Ansar Z Vance; Susan Shamimi-Noori; Gregory P Nadolski; Shilpa Reddy; Kathleen M Kratz; Jonas W Redmond; Timothy W I Clark Journal: Cardiovasc Intervent Radiol Date: 2020-02-10 Impact factor: 2.740