Transradial cerebral angiography becomes more efficient than transfemoral angiography: lessons from 500 consecutive angiograms.

Autor:	Wilkinson DA; Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA., Majmundar N; Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA., Catapano JS; Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA., Fredrickson VL; Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA., Cavalcanti DD; Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA., Baranoski JF; Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA., Rutledge C; Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA., Ducruet AF; Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA., Albuquerque FC; Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA neuropub@barrowneuro.org.
Jazyk:	angličtina
Zdroj:	Journal of neurointerventional surgery [J Neurointerv Surg] 2022 Apr; Vol. 14 (4), pp. 397-402. Date of Electronic Publication: 2021 Jun 03.
DOI:	10.1136/neurintsurg-2021-017391
Abstrakt:	Background: Transradial arterial access (TRA) for cerebral diagnostic angiography is associated with fewer access site complications than transfemoral access (TFA). However, concerns about increased procedure time and radiation exposure with TRA may slow its adoption. Our objective was to measure TRA rates of success and fluoroscopy time per vessel after 'radial-first' adoption and to compare these rates to those obtained with TFA. Methods: We examined 500 consecutive cerebral angiograms on an intent-to-treat basis during the first full year of radial-first adoption, recording patient and procedural characteristics and outcomes. Results: Over a 9-month period at a single center, 457 of 500 angiograms (91.4%) were performed with intent-to-treat via TRA, and 431 cases (86.2%) were ultimately performed via TRA. One patient (0.2%) experienced a temporary neurologic deficit in the TRA group, and none (0%) did in the TFA group (p=0.80). The mean±SD fluoroscopy time per vessel decreased significantly from the first half of the study to the second half for TRA (5.0±3.8 vs 3.4±3.5 min/vessel; p<0.001), while TFA time remained unchanged (3.7±1.8 vs 3.5±1.4 min/vessel; p=0.69). The median fluoroscopy time per vessel for TRA became faster than that for TFA after 150 angiograms. Conclusion: Of 500 consecutive angiograms performed during the first full year of radial-first implementation, 86.2% were performed successfully using TRA. TRA efficiency exceeded that of TFA after 150 angiograms. Concerns about the length of procedure or radiation exposure should not be barriers to TRA adoption. Competing Interests: Competing interests: AFD is a consultant for Stryker (Kalamazoo, MI), Cerenovus (Johnson & Johnson, New Brunswick, NJ), Medtronic (Dublin, Ireland), Penumbra (Alameda, CA), and Koswire, Inc (Flowery Branch, GA); and serves on the editorial board of Journal of NeuroInterventional Surgery. FCA serves on the editorial board of Journal of NeuroInterventional Surgery. (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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