|ECR 2018 / C-0873|
|Transradial access in arterial embolisation procedures: a single centre experience|
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 radial approach to femoral approach (5). The TRA can be used in arterial embolisation procedures in case of contraindications to TFA (INR ≥ 1,5 , platelet value <50000 , ECOG performance status 3-4). Moreover, taking into account advantages of TRA listed above, it could become the front line approach.
As regard the contraindications, transradial approach should be avoided in case of radial artery (RA) diameter smaller than 2mm (unless using 4F system), RA corkscrewed and dialysis fistula (6,7). The main contraindication to TRA is a “D waveform”showed by Barbeau test. The “type D waveform” is related to a poor ulnar compensation following radial occlusion (8).Until now, patients not suitable for radial access underwent TFA. Recently Kiemeneij et al proposed an even more distal access called “distal transradial approach”, for interventional procedure with contraindications both to the TFA and TRA. Distal transradial access is performed through the deep palmar arch at the level of anatomical snuffbox (7).
This study describes single center’s experience on TRA for arterial embolisation (AE) procedures, reporting technical success, safety and complications developed during emergency procedures too.
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