Transradial cerebral angiography becomes more efficient than transfemoral angiography: lessons from 500 consecutive angiograms

Document Type

Article

Abstract

BACKGROUND: Transradial arterial access (TRA) for cerebral diagnostic angiography is associated with fewer access site complications than transfemoral access (TFA). However, concerns about increased procedure time and radiation exposure with TRA may slow its adoption. Our objective was to measure TRA rates of success and fluoroscopy time per vessel after 'radial-first' adoption and to compare these rates to those obtained with TFA. METHODS: We examined 500 consecutive cerebral angiograms on an intent-to-treat basis during the first full year of radial-first adoption, recording patient and procedural characteristics and outcomes. RESULTS: Over a 9-month period at a single center, 457 of 500 angiograms (91.4%) were performed with intent-to-treat via TRA, and 431 cases (86.2%) were ultimately performed via TRA. One patient (0.2%) experienced a temporary neurologic deficit in the TRA group, and none (0%) did in the TFA group (p=0.80). The mean±SD fluoroscopy time per vessel decreased significantly from the first half of the study to the second half for TRA (5.0±3.8 vs 3.4±3.5 min/vessel; p<0.001), while TFA time remained unchanged (3.7±1.8 vs 3.5±1.4 min/vessel; p=0.69). The median fluoroscopy time per vessel for TRA became faster than that for TFA after 150 angiograms. CONCLUSION: Of 500 consecutive angiograms performed during the first full year of radial-first implementation, 86.2% were performed successfully using TRA. TRA efficiency exceeded that of TFA after 150 angiograms. Concerns about the length of procedure or radiation exposure should not be barriers to TRA adoption.

Keywords

aneurysm, angiography, artery, catheter, technique

Medical Subject Headings

Cerebral Angiography (methods); Femoral Artery (diagnostic imaging); Fluoroscopy (adverse effects); Humans; Radial Artery (diagnostic imaging); Radiation Exposure; Treatment Outcome

Publication Date

4-1-2022

Publication Title

Journal of neurointerventional surgery

E-ISSN

1759-8486

Volume

14

Issue

4

First Page

397

Last Page

402

PubMed ID

34083399

Digital Object Identifier (DOI)

10.1136/neurintsurg-2021-017391

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