Emergency Percutaneous Coronary Intervention Through the Left Radial Artery is Associated with Less Vascular Complications than Emergency Percutaneous Coronary Intervention Through the Femoral Artery

Qi, Guoqing; Sun, Qi; Xia, Yue; Wei, Liye

doi:10.6061/clinics/2017(01)01

Cited by 9 publications

(7 citation statements)

References 14 publications

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“…Results show that there was no significant difference in catheter placement time or the ultimate success rate of the procedure between the two groups. However, the left radial artery group showed a significantly lower incidence of vascular complications than the femoral artery group (P < 0.05) [43].…”

Section: Right Vs Left Radial Access In Acute Myocardial Infarctionmentioning

confidence: 80%

Radial Access in Primary PCI for Acute Myocardial Infarction

Heshmat¹,

Haddad²,

Farouk³

et al. 2017

Interventional Cardiology

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Transradial approach (TRA) is now considered the standard of care in many centers for elective and primary percutaneous coronary intervention (PCI). The use of the radial approach in ST-segment elevation myocardial infarction (STEMI) patients has been associated with a significant reduction in major adverse cardiac events. However, it is still unclear if the side of radial access (right vs. left) has impact on safety and effectiveness of TRA in primary PCI. So this chapter was conducted to summarize the benefits of transradial access over transfemoral access based on the most recent studies and to compare between using either right radial or left radial as an access for transradial procedure.

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Section: Right Vs Left Radial Access In Acute Myocardial Infarctionmentioning

confidence: 80%

Radial Access in Primary PCI for Acute Myocardial Infarction

Heshmat¹,

Haddad²,

Farouk³

et al. 2017

Interventional Cardiology

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“…Secondly, several studies had shown that neurointerventional via TRA can reduce the discomfort of patients after interventional surgery, and reduce the cost of surgery, and length of hospital stay compared to TFA (3,11,(35)(36)(37). Especially for patients taking anticoagulants, pregnant women, patients with severe iliac atherosclerosis, bovine arch, type II/III aortic arch, the TRA should be the main access for FD in the treatment of intracranial aneurysms (11,38,39).…”

Section: Discussionmentioning

confidence: 99%

Feasibility and Safety of Flow Diversion in the Treatment of Intracranial Aneurysms via Transradial Approach: A Single-Arm Meta-Analysis

et al. 2022

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BackgroundWhile studies have confirmed that flow diversion (FD) can treat intracranial aneurysms via transradial approach (TRA), it remains unclear whether their treatment ultimately impacts safety and feasibility. We aim to conduct a systematic review and meta-analysis assessing the safety and feasibility after FD treatment of intracranial aneurysms via TRA.MethodsPubMed, EMBASE, and Web of Science were systematically reviewed. The primary outcomes were the success rate and the access-related complications of deploying FD via TRA. Meta-analysis was performed using a random or fixed effect model based on heterogeneity. And the publication bias was evaluated using a funnel plot. This study was registered with PROSPERO, number CRD42021244448.ResultsData from 8 studies met inclusion criteria (250 non-duplicated patients). The success rate was 93% (95% confidence interval [CI] 0.86–0.98; I2 = 61.05%; p = 0.01). The access-related complications rate was 1% (95% CI 0–0.03; I2 = 0.00%; p < 0.01). The mainly access-related complications included radial artery spasm (85.7%) and radial artery occlusion (14.3%). The TRA convert to transfemoral approach (TFA) was 7% (95% CI 0.02–0.14; I2 = 61.05%; p = 0.01).ConclusionsAlthough TFA is still the main access for FD in the treatment of intracranial aneurysms, the TRA also has a higher success rate and lower access-related complications rate. With the improvement of future experience and equipment, the TRA may become the main access for FD which has more advantages. Future studies should design prospective, multicenter randomized controlled studies for long-term follow-up.

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“…TRA procedures allow for improved hemostasis, fewer access site complications, decreased postprocedure discomfort, and lower hospital cost. [17][18][19][20][21] In neurointerventional procedures, TRA access is effective and appears to be safer than TFA approaches, with less severe complications. 1,2,22 Although a paradigm shift to a "radial-first" approach for neurovascular treatments is currently underway, there is still hesitation regarding the widespread use of TRA access for neurointervention.…”

Section: Discussionmentioning

confidence: 99%

Propensity-Adjusted Comparative Analysis of Radial Versus Femoral Access for Neurointerventional Treatments

et al. 2021

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BACKGROUND Transradial artery (TRA) catheterization for neuroendovascular procedures is associated with a lower risk of complications than transfemoral artery (TFA) procedures. However, the majority of literature on TRA access pertains to diagnostic procedures rather than interventional treatments. OBJECTIVE To compare TRA and TFA approaches for cerebrovascular interventions. METHODS All patients with an endovascular intervention performed at a single center from October 1, 2018 to December 31, 2019 were retrospectively analyzed. Patients were grouped into 2 cohorts on the basis of whether TRA or TFA access was used. Outcomes included complications, fluoroscopy times, and total contrast administered. RESULTS A total 579 interventional treatments were performed during the 15-mo study period. TFA procedures (n = 417) were associated with a significantly higher complication rate than TRA (n = 162) procedures (43 cases [10%] vs 5 cases [3%]; P = .008). After excluding patients who underwent thrombectomy and performing a propensity adjustment (including age, sex, pathology, procedure, sheath size, and catheter size), TRA catheterization was associated with decreased odds of a complication (odds ratio, 0.25; 95% CI 0.085-0.72; P = .01), but no significant difference in the amount of contrast administered (6.7-mL increase; 95% CI, −7.2 to 20.6; P = .34) or duration of fluoroscopy (2.1-min increase; 95% CI, −2.5 to 6.7; P = .37) compared with TFA catheterization. CONCLUSION Neurointerventional procedures and treatments for a variety of pathologies can be performed successfully using the TRA approach, which is associated with a lower risk of complications and no difference in fluoroscopy duration compared with the TFA approach.

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Emergency Percutaneous Coronary Intervention Through the Left Radial Artery is Associated with Less Vascular Complications than Emergency Percutaneous Coronary Intervention Through the Femoral Artery

Cited by 9 publications

References 14 publications

Radial Access in Primary PCI for Acute Myocardial Infarction

Radial Access in Primary PCI for Acute Myocardial Infarction

Feasibility and Safety of Flow Diversion in the Treatment of Intracranial Aneurysms via Transradial Approach: A Single-Arm Meta-Analysis

Propensity-Adjusted Comparative Analysis of Radial Versus Femoral Access for Neurointerventional Treatments

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