Prospective Study on Total Fluoroscopic Time in Patients Undergoing Uterine Artery Embolization: Comparing Transradial and Transfemoral Approaches

Mortensen, Chloe; Chung, Jonathan; Liu, David; Ho, Stephen; Legiehn, Gerald M.; Machan, Lindsay; Klass, Darren

doi:10.1007/s00270-018-2100-3

Cited by 27 publications

(20 citation statements)

References 24 publications

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“…Upper extremity and tibiopedal arterial access provide significant patient and operator benefits during percutaneous angiography and intervention. Transpedal access has been increasingly utilized in lower extremity revascularization during treatment of femoral-popliteal and tibioperoneal disease [10,11], and advantages of radial artery access for percutaneous coronary and peripheral intervention are well described [1][2][3][4][5][6][7][8][9]. Both access methods facilitate reduction in access site complications and time to patient ambulation; refined protocols for achieving hemostasis at these access sites may enable further improvement in patient safety and comfort to meet increasing demand for arterial access through these approaches.…”

Section: Discussionmentioning

confidence: 99%

“…The benefits of radial artery access relative to common femoral artery access are well studied: decreased bleeding and vascular complications, increased patient comfort and satisfaction, decreased time to hemostasis, and in the setting of percutaneous coronary intervention for ST-elevation myocardial infarction, significantly lower mortality [1][2][3][4]. Radial access is also used during noncoronary interventions [5], also showing improved patient satisfaction [6][7][8][9]. Retrograde tibiopedal access offers several mechanical advantages in the setting of lower extremity revascularization and may allow for successful endovascular treatment of tibioperoneal and femoropopliteal disease when antegrade-only techniques have failed [10,11].…”

Section: Introductionmentioning

confidence: 99%

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Nonfemoral Arterial Hemostasis Following Percutaneous Intervention Using a Focused Compression Device

Barrette

Vance

Shamimi-Noori

et al. 2020

Cardiovasc Intervent Radiol

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Purpose Upper extremity and tibiopedal arterial access are increasingly used during endovascular therapies. Balloon compression hemostasis devices in these anatomic locations have been described, but most utilize a compression surface extending well beyond the puncture site. We report single-center experience with an arterial puncture-focused compression device following upper extremity and tibiopedal access. Patients and Methods A series of 249 focused compression hemostasis devices (VasoStat, Forge Medical, Bethlehem, Pennsylvania, USA) were used in 209 patients following lower extremity (n = 63) and upper extremity (n = 186; radial: 90%) arterial access procedures using 4-7 French sheaths. Demographic, operative, and follow-up data were collected. Logistic regression was used to evaluate potential association between patient/operative variables and time to hemostasis. Results Primary hemostasis was achieved in 97.2% (242/ 249) following sheath removal; in 7 cases (2.8%) puncture site oozing occurred after initial device removal and required reapplication. Secondary hemostasis was 100% (249/249). Seven complications (2.8%) were recorded: 5 minor hematomas (2%) and 2 transient access artery occlusions (0.8%). Mean time to hemostasis enabling device removal was 55 ± 28 min. Elevated body mass index (BMI) was not associated with increased time to hemostasis (p = 0.31). Accessed artery, sheath size, and heparin dose were also not associated with time to hemostasis (p = 0.64; p = 0.74; p = 0.75, respectively). Conclusions The focused compression hemostasis device enabled rapid hemostasis with a low complication rate. Time to hemostasis was independent of BMI, access site, sheath size, or heparin dose.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Nonfemoral Arterial Hemostasis Following Percutaneous Intervention Using a Focused Compression Device

Barrette

Vance

Shamimi-Noori

et al. 2020

Cardiovasc Intervent Radiol

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“…However, this study did not provide a comparison between TFA and TRA in terms of its efficacy in treating uterine fibroid embolization. Mortensen et al (42) compared 39 TFA and 27 TRA uterine fibroid embolization procedures and showed comparable fluoroscopy time. Nakhaei et al (10) compared 91 TFA and 91 TRA uterine fibroid embolization procedures and demonstrated comparable technical and clinical outcomes between the two approaches.…”

Section: Uaementioning

confidence: 99%

Update on Transradial Access for Percutaneous Transcatheter Visceral Artery Embolization

et al. 2021

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Transfemoral access (TFA) is a widely used first-line approach for most peripheral vascular interventions. Since its introduction in cardiologic and neurointerventional procedures, several advantages of transradial access (TRA) over TFA have been demonstrated, such as patient preference, lower complication rates, early ambulation, and shorter hospital stay. However, studies reporting the safety and efficacy of this approach for peripheral vascular interventions performed by interventional radiologists are relatively few. This review aimed to summarize the technique and clinical applications of TRA in percutaneous transcatheter visceral artery embolization and the management of complications.

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“…4 5 TRA has been described by a some authors for iliac and uterine interventions with excellent clinical results and acceptable fluoroscopic times. [6][7][8][9] Advantages include fewer hemorrhagic complications, notably eliminating the risk for the rare but deadly retroperitoneal hematoma, increased post-procedural comfort and, as in the presented case, access to vessels that would not be reachable through the transfemoral approach. Device size and length are key considerations in TRA.…”

Section: Discussionmentioning

confidence: 79%

Republished: Transradial approach in the treatment of a sacral dural arteriovenous fistula: a technical note

Orrù

Tsang

Klostranec

et al. 2019

J NeuroIntervent Surg

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Sacral dural arteriovenous fistulas (SDAVFs) are rare, constituting no more than 10% of all spinal dural fistulas. They are most commonly fed by the lateral sacral artery (LSA), a branch of the internal iliac artery (IIA). Catheterization of this vessel requires either a crossover at the aortic bifurcation in cases of right femoral access or retrograde catheterization from the ipsilateral common femoral artery. We present the case of a 79-year-old man with tethered cord syndrome and a symptomatic SDAVF fed by two feeders from the left LSA. Spinal diagnostic angiography was made exceptionally challenging by an aorto-bi-iliac endograft, and selective catheterization of the left IIA was not possible. The patient could not undergo surgery due to multiple comorbidities, therefore embolization was considered the best approach. The procedure was carried out through a transradial access (TRA) with Onyx and n-butyl cyanoacrylate. The SDAVF was successfully treated and the patient made a full neurological recovery.

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Prospective Study on Total Fluoroscopic Time in Patients Undergoing Uterine Artery Embolization: Comparing Transradial and Transfemoral Approaches

Cited by 27 publications

References 24 publications

Nonfemoral Arterial Hemostasis Following Percutaneous Intervention Using a Focused Compression Device

Nonfemoral Arterial Hemostasis Following Percutaneous Intervention Using a Focused Compression Device

Update on Transradial Access for Percutaneous Transcatheter Visceral Artery Embolization

Republished: Transradial approach in the treatment of a sacral dural arteriovenous fistula: a technical note

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