Avnesh S Thakor1, Mohammed T Alshammari2, David M Liu3, John Chung3, Stephen G F Ho3, Gerald M Legiehn3, Lindsay Machan3, Aaron M Fischman4, Rahul S Patel4, Darren Klass5. 1. Department of Interventional Radiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada; Department of Radiology, Stanford University Medical Center, Palo Alto, California, USA. 2. Department of Interventional Radiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada; Department of Interventional Radiology, Security Forces Hospital, Riyadh, Saudi Arabia. 3. Department of Interventional Radiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada. 4. Department of Interventional Radiology, The Mount Sinai Health System, New York, New York, USA. 5. Department of Interventional Radiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: darren.klass@vch.ca.
Abstract
PURPOSE: The study sought to describe a single centre's technical approach to transradial intervention and report on clinical outcomes and safety. METHODS: A total of 749 transradial access (TRA) procedures were performed at a single hospital in 562 patients (174 women and 388 men). Procedures included 445 bland embolizations or chemoembolizations of the liver, 88 uterine artery embolizations, and 148 procedures for Selective Internal Radiation Therapy (Y90), which included mapping and administration. The mean age of the patients was 62 years (range 27-96 years). RESULTS: Four cases (0.5%) required crossover to transfemoral (tortuous anatomy, inability to secure a stable position for embolization, vessel spasm and base catheter not being of a sufficient length). A single asymptomatic, short-segment radial artery occlusion occurred (0.3%), 3 patients (0.4%) developed small hematomas postprocedurally, and 2 patients (0.7%) had transient neurological pain, which was resolved within a week without treatment. It was found that 98% of patients who had a previous femoral access procedure would choose radial access for subsequent procedures. CONCLUSIONS: Transradial access is a safe, effective technique, with a learning curve; however, this procedure has the potential to significantly improve departmental workflow and cost savings for the department and patient experience.
PURPOSE: The study sought to describe a single centre's technical approach to transradial intervention and report on clinical outcomes and safety. METHODS: A total of 749 transradial access (TRA) procedures were performed at a single hospital in 562 patients (174 women and 388 men). Procedures included 445 bland embolizations or chemoembolizations of the liver, 88 uterine artery embolizations, and 148 procedures for Selective Internal Radiation Therapy (Y90), which included mapping and administration. The mean age of the patients was 62 years (range 27-96 years). RESULTS: Four cases (0.5%) required crossover to transfemoral (tortuous anatomy, inability to secure a stable position for embolization, vessel spasm and base catheter not being of a sufficient length). A single asymptomatic, short-segment radial artery occlusion occurred (0.3%), 3 patients (0.4%) developed small hematomas postprocedurally, and 2 patients (0.7%) had transient neurological pain, which was resolved within a week without treatment. It was found that 98% of patients who had a previous femoral access procedure would choose radial access for subsequent procedures. CONCLUSIONS: Transradial access is a safe, effective technique, with a learning curve; however, this procedure has the potential to significantly improve departmental workflow and cost savings for the department and patient experience.
Authors: Matthew L Hung; Edward W Lee; Justin P McWilliams; Siddharth A Padia; Pengxu Ding; Stephen T Kee Journal: Eur Radiol Date: 2018-06-20 Impact factor: 5.315
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