Propensity-Adjusted Comparative Analysis of Radial Versus Femoral Access for Neurointerventional Treatments.
Neurosurgery
; 88(6): E505-E509, 2021 05 13.
Article
in En
| MEDLINE
| ID: mdl-33582816
ABSTRACT
BACKGROUND:
Transradial artery (TRA) catheterization for neuroendovascular procedures is associated with a lower risk of complications than transfemoral artery (TFA) procedures. However, the majority of literature on TRA access pertains to diagnostic procedures rather than interventional treatments.OBJECTIVE:
To compare TRA and TFA approaches for cerebrovascular interventions.METHODS:
All patients with an endovascular intervention performed at a single center from October 1, 2018 to December 31, 2019 were retrospectively analyzed. Patients were grouped into 2 cohorts on the basis of whether TRA or TFA access was used. Outcomes included complications, fluoroscopy times, and total contrast administered.RESULTS:
A total 579 interventional treatments were performed during the 15-mo study period. TFA procedures (n = 417) were associated with a significantly higher complication rate than TRA (n = 162) procedures (43 cases [10%] vs 5 cases [3%]; P = .008). After excluding patients who underwent thrombectomy and performing a propensity adjustment (including age, sex, pathology, procedure, sheath size, and catheter size), TRA catheterization was associated with decreased odds of a complication (odds ratio, 0.25; 95% CI 0.085-0.72; P = .01), but no significant difference in the amount of contrast administered (6.7-mL increase; 95% CI, -7.2 to 20.6; P = .34) or duration of fluoroscopy (2.1-min increase; 95% CI, -2.5 to 6.7; P = .37) compared with TFA catheterization.CONCLUSION:
Neurointerventional procedures and treatments for a variety of pathologies can be performed successfully using the TRA approach, which is associated with a lower risk of complications and no difference in fluoroscopy duration compared with the TFA approach.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Catheterization, Peripheral
/
Cerebrovascular Disorders
/
Radial Artery
/
Femoral Artery
/
Endovascular Procedures
Type of study:
Observational_studies
/
Risk_factors_studies
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Neurosurgery
Year:
2021
Document type:
Article
Affiliation country:
United States