Transradial access for renal artery intervention

Abstract

Abstract:Introduction: Percutaneous interventional procedures in the renal arteries are usually performed using a femoral or brachial vascular access. The transradial approach is becoming more popular for peripheral interventions, but limited data exists for renal artery angioplasty and stenting. Methods: We have analyzed the clinical, angiographic and technical results of renal artery stenting performed from radial artery access between 2012 and 2013. The radial artery anatomy was identifi ed with aortography using 100 cm pig tail catheter. After engagement of the renal artery ostium with a 6F Multipurpose or 6F JR5 guiding catheter, the stenosis was passed with a 0.014" guidewire followed by angioplasty and stent implantation. Results: In 27 patients (mean age: 65.4 ± 9.17) with hemodynamically relevant renal artery stenosis (mean diameter stenosis: 77.7 ± 10.6%; right, n = 7; left, n = 20), interventional treatment with angioplasty and stenting was performed using a left (n = 3) or right (n = 24) radial artery access. Direct stenting was successfully performed in 13 (48%) cases, and predilatations were required in ten cases 10 (37%). Primary technical success (residual stenosis <30%) could be achieved in all cases. The mean contrast consumption was 119 ± 65 ml and the mean procedure time was 30 ± 8.2 min. There were no major periprocedural vascular complications and in one patient transient creatinine level elevation was observed (3.7%). In one patient asymptomatic radial artery occlusion was detected (3.7%). Conclusion: Transradial renal artery angioplasty and stenting is technically feasible and safe procedure.

Hepatic radioembolization from transradial access: initial experience and comparison to transfemoral access

“…According to our knowledge, there are only a few hospitals where radial access is regularly performed for interventions in the systemic circulation. Most of the related publications report the use of radial access for cerebral angiograms and carotid artery stenting (16,17) and only a few report procedures below the diaphragm (11)(12)(13)(14)(15). Only three groups reported abdominal or pelvic visceral interventions in the English literature.…”

“…Only three groups reported abdominal or pelvic visceral interventions in the English literature. A group at Tokyo Women's Medical University Daini Hospital (Tokyo, Japan) reported that they performed abdominal interventions in 426 patients between 2000 and 2004 via the transradial approach, including 177 cases of transarterial hepatic chemoemboli-zations (15,22); Ruzsa et al (14) reported renal artery angioplasty and stenting in 27 patients; Resnick et al (13) reported uterine artery embolization in 29 patients.…”

“…use of radial access for procedures in the systemic circulation (11)(12)(13)(14)(15), and the majority of these reports are related to cerebral angiograms and carotid stenting (16,17). According to our knowledge, there is only one peer-reviewed publication which compares radial to femoral approach for a procedure in the systemic circulation (15); Shiozawa et al (15) investigated the therapeutic efficacy and safety of the transradial approach for transarterial chemoembolization in patients with hepatocellular carcinoma and compared it with the conventional transfemoral approach.…”

Transradial Approach for Noncoronary Interventions: A Single-Center Review of Safety and Feasibility in the First 1,500 Cases

“…Despite this shift in access site preference among interventional cardiologists, TFA remains the predominant access site choice for peripheral and visceral interventions. Literature examining the feasibility of TRA for noncoronary interventions is relatively sparse, although its safety and feasibility have been described for uterine artery embolization (8), renal artery intervention (9), and transarterial chemoembolization (10). In a 2003 study by Shiozawa et al (10), overall access site complications were found to be significantly less in TRA versus TFA in treating hepatocellular carcinoma via transarterial chemoembolization (4.5% vs 12.7%), while maintaining comparable therapeutic efficacy.…”

A Novel Technique of Stenting of the Renal Artery In-Stent Restenosis with GuideLiner® through Radial Approach

“…There is a paucity of data in the literature describing renal artery interventions through radial site access [ 11 ]. To the best of our knowledge, this is the first case illustrating the novel technique of percutaneous transluminal balloon angioplasty and DES placement with the assistance of GL through radial access in the complex ISR of the renal artery.…”