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Clinical experience with distal transradial access for endovascular treatment of various noncoronary interventions in a multicenter study
Transradial access is a well-known alternative to conventional transfemoral access for interventional procedures. Recently, transradial access through the "snuffbox", which lies in the radial dorsal aspect of the hand, has been introduced as a new technique with positional versatility. In...
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Published in: | PloS one 2020-08, Vol.15 (8), p.e0237798-e0237798 |
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description | Transradial access is a well-known alternative to conventional transfemoral access for interventional procedures. Recently, transradial access through the "snuffbox", which lies in the radial dorsal aspect of the hand, has been introduced as a new technique with positional versatility. In this study, we aimed to evaluate the clinical feasibility and safety of distal transradial access for interventional procedures in a retrospective, multicenter study. Distal transradial access was attempted in 46 patients (36 men and 10 women; mean age, 64 years) who underwent 47 consecutive procedures from January 2018 to December 2019. Procedures included chemoembolization (19/47, 40.4%), bronchial artery embolization (7/47, 14.9%), renal intervention (3/47, 6.4%), arteriovenous fistula angioplasty (7/47, 14.9%), subclavian artery stenting (5/47, 10.6%), other embolization (5/47, 10.6%), and uterine artery embolization (1/47, 2.1%). We recorded the success rate of the procedures, complications, and postprocedural hemostasis time during the follow-up period. The technical success of distal transradial access without major complications was 97.9% (46/47). Of the 46 patients, one patient (2.2%) had a minor complication, which was a thrombotic segmental occlusion of the distal radial artery. Of the enrolled patients, only one patient did not complete the transradial access procedure via the snuffbox because the left proximal subclavian artery was occluded and a crossover to conventional transfemoral access was performed. The mean postprocedural hemostasis time was 131.7 minutes (range, 120-360 minutes). Distal transradial access can be a valid option for the endovascular treatment of various noncoronary interventions with technical feasibility and safety. |
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Recently, transradial access through the "snuffbox", which lies in the radial dorsal aspect of the hand, has been introduced as a new technique with positional versatility. In this study, we aimed to evaluate the clinical feasibility and safety of distal transradial access for interventional procedures in a retrospective, multicenter study. Distal transradial access was attempted in 46 patients (36 men and 10 women; mean age, 64 years) who underwent 47 consecutive procedures from January 2018 to December 2019. Procedures included chemoembolization (19/47, 40.4%), bronchial artery embolization (7/47, 14.9%), renal intervention (3/47, 6.4%), arteriovenous fistula angioplasty (7/47, 14.9%), subclavian artery stenting (5/47, 10.6%), other embolization (5/47, 10.6%), and uterine artery embolization (1/47, 2.1%). We recorded the success rate of the procedures, complications, and postprocedural hemostasis time during the follow-up period. The technical success of distal transradial access without major complications was 97.9% (46/47). Of the 46 patients, one patient (2.2%) had a minor complication, which was a thrombotic segmental occlusion of the distal radial artery. Of the enrolled patients, only one patient did not complete the transradial access procedure via the snuffbox because the left proximal subclavian artery was occluded and a crossover to conventional transfemoral access was performed. The mean postprocedural hemostasis time was 131.7 minutes (range, 120-360 minutes). Distal transradial access can be a valid option for the endovascular treatment of various noncoronary interventions with technical feasibility and safety.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0237798</identifier><identifier>PMID: 32822396</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Angioplasty ; Biology and Life Sciences ; Cardiovascular system ; Care and treatment ; Complications ; Embolization ; Engineering and Technology ; Feasibility studies ; Health aspects ; Hemostasis ; Hemostatics ; Hospitals ; Ischemia ; Medical imaging ; Medicine ; Medicine and Health Sciences ; Methods ; Occlusion ; Patients ; Physiological aspects ; Radius (Anatomy) ; Research and Analysis Methods ; Safety ; Uterus ; Vascular surgery ; Veins & arteries</subject><ispartof>PloS one, 2020-08, Vol.15 (8), p.e0237798-e0237798</ispartof><rights>COPYRIGHT 2020 Public Library of Science</rights><rights>2020 Park et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 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Recently, transradial access through the "snuffbox", which lies in the radial dorsal aspect of the hand, has been introduced as a new technique with positional versatility. In this study, we aimed to evaluate the clinical feasibility and safety of distal transradial access for interventional procedures in a retrospective, multicenter study. Distal transradial access was attempted in 46 patients (36 men and 10 women; mean age, 64 years) who underwent 47 consecutive procedures from January 2018 to December 2019. Procedures included chemoembolization (19/47, 40.4%), bronchial artery embolization (7/47, 14.9%), renal intervention (3/47, 6.4%), arteriovenous fistula angioplasty (7/47, 14.9%), subclavian artery stenting (5/47, 10.6%), other embolization (5/47, 10.6%), and uterine artery embolization (1/47, 2.1%). We recorded the success rate of the procedures, complications, and postprocedural hemostasis time during the follow-up period. The technical success of distal transradial access without major complications was 97.9% (46/47). Of the 46 patients, one patient (2.2%) had a minor complication, which was a thrombotic segmental occlusion of the distal radial artery. Of the enrolled patients, only one patient did not complete the transradial access procedure via the snuffbox because the left proximal subclavian artery was occluded and a crossover to conventional transfemoral access was performed. The mean postprocedural hemostasis time was 131.7 minutes (range, 120-360 minutes). Distal transradial access can be a valid option for the endovascular treatment of various noncoronary interventions with technical feasibility and safety.</description><subject>Angioplasty</subject><subject>Biology and Life Sciences</subject><subject>Cardiovascular system</subject><subject>Care and treatment</subject><subject>Complications</subject><subject>Embolization</subject><subject>Engineering and Technology</subject><subject>Feasibility studies</subject><subject>Health aspects</subject><subject>Hemostasis</subject><subject>Hemostatics</subject><subject>Hospitals</subject><subject>Ischemia</subject><subject>Medical imaging</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Methods</subject><subject>Occlusion</subject><subject>Patients</subject><subject>Physiological aspects</subject><subject>Radius (Anatomy)</subject><subject>Research and Analysis Methods</subject><subject>Safety</subject><subject>Uterus</subject><subject>Vascular 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study</atitle><jtitle>PloS one</jtitle><date>2020-08-21</date><risdate>2020</risdate><volume>15</volume><issue>8</issue><spage>e0237798</spage><epage>e0237798</epage><pages>e0237798-e0237798</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Transradial access is a well-known alternative to conventional transfemoral access for interventional procedures. Recently, transradial access through the "snuffbox", which lies in the radial dorsal aspect of the hand, has been introduced as a new technique with positional versatility. In this study, we aimed to evaluate the clinical feasibility and safety of distal transradial access for interventional procedures in a retrospective, multicenter study. Distal transradial access was attempted in 46 patients (36 men and 10 women; mean age, 64 years) who underwent 47 consecutive procedures from January 2018 to December 2019. Procedures included chemoembolization (19/47, 40.4%), bronchial artery embolization (7/47, 14.9%), renal intervention (3/47, 6.4%), arteriovenous fistula angioplasty (7/47, 14.9%), subclavian artery stenting (5/47, 10.6%), other embolization (5/47, 10.6%), and uterine artery embolization (1/47, 2.1%). We recorded the success rate of the procedures, complications, and postprocedural hemostasis time during the follow-up period. The technical success of distal transradial access without major complications was 97.9% (46/47). Of the 46 patients, one patient (2.2%) had a minor complication, which was a thrombotic segmental occlusion of the distal radial artery. Of the enrolled patients, only one patient did not complete the transradial access procedure via the snuffbox because the left proximal subclavian artery was occluded and a crossover to conventional transfemoral access was performed. The mean postprocedural hemostasis time was 131.7 minutes (range, 120-360 minutes). Distal transradial access can be a valid option for the endovascular treatment of various noncoronary interventions with technical feasibility and safety.</abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>32822396</pmid><doi>10.1371/journal.pone.0237798</doi><tpages>e0237798</tpages><orcidid>https://orcid.org/0000-0001-5762-7064</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Angioplasty Biology and Life Sciences Cardiovascular system Care and treatment Complications Embolization Engineering and Technology Feasibility studies Health aspects Hemostasis Hemostatics Hospitals Ischemia Medical imaging Medicine Medicine and Health Sciences Methods Occlusion Patients Physiological aspects Radius (Anatomy) Research and Analysis Methods Safety Uterus Vascular surgery Veins & arteries |
title | Clinical experience with distal transradial access for endovascular treatment of various noncoronary interventions in a multicenter study |
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