PT - JOURNAL ARTICLE AU - Catapano, Joshua S AU - Fredrickson, Vance L AU - Fujii, Tatsuhiro AU - Cole, Tyler S AU - Koester, Stefan W AU - Baranoski, Jacob F AU - Cavalcanti, Daniel D AU - Wilkinson, D Andrew AU - Majmundar, Neil AU - Lang, Michael J AU - Lawton, Michael T AU - Ducruet, Andrew F AU - Albuquerque, Felipe C TI - Complications of femoral versus radial access in neuroendovascular procedures with propensity adjustment AID - 10.1136/neurintsurg-2019-015569 DP - 2020 Jun 01 TA - Journal of NeuroInterventional Surgery PG - 611--615 VI - 12 IP - 6 4099 - http://jnis.bmj.com/content/12/6/611.short 4100 - http://jnis.bmj.com/content/12/6/611.full SO - J NeuroIntervent Surg2020 Jun 01; 12 AB - Background The transradial artery (TRA) approach for neuroendovascular procedures continues to gain popularity, but neurointerventionalists still lag behind interventional cardiologists in the adoption of a TRA-first approach. This study compares the complications and efficiency of the TRA approach to the standard transfemoral artery (TFA) approach at our institution during our initial phase of adopting a TRA-first approach.Methods A retrospective analysis was performed on all consecutive neuroangiographic procedures performed at a large cerebrovascular center from October 1, 2018 to June 30, 2019. The standard TFA approach was compared with TRA access, with the primary outcome of complications analyzed via a propensity-adjusted analysis.Results A total of 1050 consecutive procedures were performed on 877 patients during this 9-month period; 206 (20%) procedures were performed via TRA and 844 (80%) via TFA. The overall complication rate was significantly higher with the TFA procedures than with the TRA procedures (7% (60/844) vs 2% (4/206), respectively; p=0.003). A propensity-adjusted analysis showed that the TFA approach was a significant risk factor for a complication (OR 3.6, 95% CI 1.3 to 10.2, p=0.01). However, the propensity analysis showed that fluoroscopy times were on average 4 min less for TFA procedures than for TRA procedures (p=0.003).Conclusion The TRA approach for neuroendovascular procedures appears to be safer than the TFA approach. Although a steep learning curve is initially encountered when adopting the TRA approach, the transition to a TRA-first practice can be performed safely for neurointerventional procedures and may reduce complications.