Distal transradial artery access for vascular access intervention

Abstract

Background: Vascular access intervention is a useful treatment method for maintaining arteriovenous fistula (AVF) in dialysis patients. The outflow vein is commonly used as the access site for vascular access intervention. In cases where it is difficult to puncture veins due to multiple lesions or poor AVF development, vascular access intervention is performed using the radial artery. However, it is difficult to perform a vascular access intervention with radial artery access to the AVF in the distal forearm. We reported the efficacy and safety of vascular access intervention with distal transradial artery access (dTRA). Case series: We have been conducting vascular access intervention with dTRA access since January 2019. We evaluated complications and procedure time for 12 cases of vascular access intervention with dTRA access performed from January to December 2019. The success rate of the procedure was 100% and no puncture hemorrhagic complication was observed in 12 cases performed at our institution. No radial artery occlusion was observed in 12 cases. The average fluoroscopy time was 11.5 min and the average contrast volume was 41 ml. Conclusion: dTRA for vascular access intervention has advantages over conventional radial artery access in terms of safety of the procedure and ease of hemostasis.

Efficacy and Safety of Distal Radial Artery Approach for Coronary Angiography: A Retrospective Study

“…The reason for this occurrence may be that the abundant alpha-adrenergic receptors in the outer vascular membrane of the artery make the radial artery prone to have higher vascular reactivity, which contributes to tem-porary and sudden vascular narrowing after local trauma [17]. Therefore, prevention of radial spasm is crucial to reduce complications and improve patient comfort, and can be prevented by sedation and analgesia before surgery, reduction of puncture times, use of an ultra-thin hydrophilic sheath, and adequate anticoagulants and vasodilators after implantation of the arterial sheath [18]. All of our patients were safely implanted with a 6 F arterial sheath and successfully completed the operation.…”

A narrative review of history, advantages, future developments of the distal radial access

“…They found RadA access to be extremely difficult, but with 100% efficiency and without complications. 36 Individual clinical cases of DRA application in stenting of the subclavian, upper mesenteric, common iliac, celiac, and renal arteries, and in embolization of bleeding bronchial and renal arteries, and renal artery aneurysm have been described. 37,38 DRA has been used in interventional oncology for liver chemoembolization, selective radiation therapy and I-90 mapping, diagnostic angiography, embolization of the uterine arteries, and mesenteric, pelvic, and oncological bleeding (gastric, hepatic, renal, and pulmonary) with technical success in almost 100% of cases.…”

“…They found RadA access to be extremely difficult, but with 100% efficiency and without complications. 36 Individual clinical cases of DRA application in stenting of the subclavian, upper mesenteric, common iliac, celiac, and renal arteries, and in embolization of bleeding bronchial and renal arteries, and renal artery aneurysm have been described. 37,38…”

The anatomical snuffbox for transradial access in arteriovenous fistula intervention: Case report and brief review of the literature

“…This small triangular area is often used to perform clinical procedures, such as cephalic vein cannulation and surgical procedures as arteriovenous fistula [4] . Iatrogenic occlusion is better tolerated with distal transradial access [5] . We report a case of intervention of an arteriovenous fistula occlusion in the left wrist via the left distal transradial access to the anatomical snuffbox.…”