Radial vs. Femoral Artery Access for Procedural Success in Diagnostic Cerebral Angiography
Autor: | Ronit Agid, Ivan Radovanovic, Hans Kortman, Patrick Nicholson, Hubert Lee, Ayman M Qureshi, Kartik Bhatia, Alexander Kostynskyy, Emanuele Orru, William Guest, Vitor Mendes Pereira, Richard I. Farb, Jesse M. Klostranec, Timo Krings |
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Rok vydání: | 2020 |
Předmět: |
medicine.medical_specialty
Percutaneous medicine.diagnostic_test business.industry Vertebral artery Femoral artery 030218 nuclear medicine & medical imaging law.invention Surgery 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law medicine.artery Multicenter trial medicine Radiology Nuclear Medicine and imaging Neurology (clinical) Radial artery business 030217 neurology & neurosurgery Cerebral angiography Neuroradiology |
Zdroj: | Clinical Neuroradiology. 31:1083-1091 |
ISSN: | 1869-1447 1869-1439 |
DOI: | 10.1007/s00062-020-00984-1 |
Popis: | Radial artery access has become the standard of care in percutaneous coronary procedures due to demonstrated patient safety and comfort benefits; however, uptake of radial access for diagnostic cerebral angiography has been limited by practitioner concerns over the ability to achieve procedural success. We aimed to provide randomized clinical trial evidence for the non-inferiority of radial access to achieve procedural success. Monocentric open label randomized controlled trial with a non-inferiority design and blinded primary outcome assessment. Adult patients referred in-hours for diagnostic cerebral angiography were eligible. Participants underwent permuted block randomization to radial or femoral artery access with an intention-to-treat analysis. The primary outcome was procedural success, defined as selective cannulation and/or diagnostic angiography of predetermined supra-aortic vessels of interest. The non-inferiority limit was 10.0%. Secondary outcomes included postprocedural complications, fluoroscopy and procedural times, radiation dose, contrast volume and rates of vertebral artery cannulation. A total of 80 participants were enrolled (female 42, male 38, mean age 47.0 years, radial access group n = 43, femoral n = 37). One patient in the radial group was excluded after enrollment due to insufficient sonographic radial artery internal diameter. Procedural success was achieved in 41 of 42 participants in the radial group (97.6%) and 36 of 37 in the femoral group (97.3%). The difference between groups was −0.3% (one-sided 95% confidence interval, CI 6.7%) and the null hypothesis was rejected. Radial artery access is non-inferior to femoral artery access for procedural success in cerebral angiography. A large multicenter trial is recommended as the next step. |
Databáze: | OpenAIRE |
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