Background and purpose The majority of neuroendovascular procedures are still performed via transfemoral access. Radial artery catheterization is an alternate route of access that has started to gain more widespread use for neuroendovascular procedures, and there have been few studies that describe its safety and efficacy. We present our institution’s experience in performing neuroendovascular interventions via a transradial approach, with excellent clinical outcomes and patient satisfaction measures.
Methods We conducted a retrospective analysis and identified 223 patients who underwent 233 consecutive neuroendovascular interventions via radial artery access at our institution. The incidence of perioperative and post-procedural complications was investigated. We identified a subset of 98 patients who have undergone both transradial and transfemoral cerebral angiograms, and compared clinical outcomes and patient satisfaction measures between the two groups.
Results The overall incidence of complications was low across all procedures performed via transradial access. Peri-procedurally, only 2 patients had symptomatic radial artery spasm, and there were no instances of iatrogenic complications (vessel dissection, stroke, hemorrhage). In 10 cases (4.3%), the intended procedure could not be completed via a transradial approach, and, thus, femoral artery access had to be pursued instead. Ten patients complained of minor post-procedural complications: superficial hematomas, swelling, and paresthesias, albeit none required therapeutic intervention. The mean procedure time was shorter for diagnostic angiograms performed via transradial vs transfemoral access (18.8±15.8 versus 39.5±31.1 minutes, p<0.05). Patients reported shorter recovery times with transradial access, and the majority of patients (94%) would elect to have subsequent procedures performed via this route.
Conclusions Radial artery catheterization is a safe and durable alternative to perform a wide range of neuroendovascular procedures, with a low rate of complications. On the whole, patients prefer transradial compared to transfemoral access, with shorter recovery times reported and overall excellent patient satisfaction.
Disclosures O. Khanna: None.
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