Percutaneous radial access for peripheral transluminal angioplasty

Abstract

This study demonstrates the feasibility of radial access for peripheral PTA. Radial access could represent an alternative to brachial access for peripheral and visceral interventions. Although complication rates of the present series are concerning, larger studies are needed to determine the role of transradial PTA once the learning curve is overcome. A wider diffusion of the technique mandates (1) smaller-diameter sheaths, (2) longer shaft devices, and (3) the development of specifically designed rescue devices such as covered stents and thromboaspiration catheters.

Treatment of peripheral arterial disease via percutaneous brachial artery access

“…5,[8][9][10][11][12] The brachial artery (BA) and radial artery (RA) have received attention in the cardiac literature but seemingly less attention for peripheral interventions. [9][10][11][12][13][14] Although some distal lesions may be out of reach from a BA approach, the advent of new longer catheters and wires have brought many of these lesions within reach. The goal of this 10-year retrospective review was to evaluate our experience with BA access for peripheral interventions.…”

Percutaneous transaxillary approach for peripheral endovascular interventions

“…Additionally, the distance to target lesions compromises operator purchase required to crossocclusions and limits its use to nonocclusive TASC A and B lesions. Moreover, the vessel size, radial artery spasm, and radial and brachial arteries tortuosity and loops can further limit its use . The transbrachial approach for diagnostic angiography and interventions has been also described.…”

“…The common femoral artery (CFA) remains the most commonly used vascular access site for peripheral endovascular interventions employing crossover, retrograde, or antegrade techniques. However, severe CFA disease, hostile groins, previous aortoiliac stents, or grafts may preclude this approach …”

“…However, severe CFA disease, hostile groins, previous aortoiliac stents, or grafts may preclude this approach. 1 Upper limb access through the brachial or radial arteries has been described. Nevertheless, transbrachial approach is associated with substantial risk of local complications such as pseudoaneurysm, artery thrombosis, or neural damage in up to 11% of cases.…”

Peripheral angioplasty as a day case: science fiction or everyday reality?

“…Another interesting approach for a day-case setting might be the access from the radial artery that has been recently described for the treatment of PAD [11]. In a paper from Coscas et al [12] the authors have treated 24 patients with PAD from a radial access as day cases. Case selection was based on the hostile groins, bilateral disease, and presence of iliac or aortic stents or stent-grafts.…”