Feasibility and Safety of the Distal Transradial Access for Noncardiac Intervention.

Takeshi Wada, Jun Koizumi, Takashi Takeuchi, Akira Akutsu, Satoshi Tsuchiya, Yoshihiro Kubota, Hiroshi Kondo, Hajime Fujimoto, Takashi Uno
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Abstract

Purpose: Distal transradial access through the anatomical snuffbox has been highlighted in recent research because it provides extremely low invasiveness. It has demonstrated its feasibility and safety for cardiac intervention. However, its characteristics for noncardiac intervention are not well known. This report aims to demonstrate the feasibility and safety of noncardiac intervention with distal transradial access, with identification of practical devices for procedures.

Material and method: This retrospective study was conducted from May 2021 to December 2021 with consecutive patients who underwent distal transradial access for noncardiac intervention. This study analyzed patient physical information, procedural details, technical success rates, and distal transradial access-associated complications.

Result: Nine patients (7 females, 2 males) aged 48-69 years (median: 57) were enrolled in this study. This study assessed 11 noncardiac procedures, such as transarterial infusion chemotherapy for head and neck malignancies (n = 4), embolization of visceral artery aneurysm (n = 2), embolization of renal angiomyolipoma (n = 2), percutaneous transluminal renal angioplasty (n = 1), bronchial artery embolization (n = 1), and diagnostic angiography (n = 1). The introducer sheath size was 4-6 French. Catheters respectively having nine tip shapes were used. Reverse curve catheters were used only in two cervical procedures. The technical success rate was 91% (10/11). Of the 11 procedures, only 1 (bronchial artery embolization) required conversion to transfemoral access. There was no complication associated with distal transradial access. Ultrasound evaluation after treatments revealed patent radial arteries in all patients.

Conclusions: Results revealed that distal transradial access is feasible with commercially available catheters and is safe for various noncardiac interventions.

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经桡动脉远端入路进行非心脏介入治疗的可行性和安全性。
目的:通过解剖鼻烟盒进行经桡动脉远端入路是近期研究的重点,因为它具有极低的侵入性。它已经证明了其在心脏介入方面的可行性和安全性。然而,它在非心脏介入方面的特点还不为人所知。本报告旨在证明经桡动脉远端入路进行非心脏介入治疗的可行性和安全性,并确定实用的手术设备:本回顾性研究于 2021 年 5 月至 2021 年 12 月期间进行,对象为接受远端经桡动脉入路非心脏介入治疗的连续患者。该研究分析了患者的身体信息、手术细节、技术成功率以及经桡动脉远端入路相关并发症:本研究共纳入 9 名患者(7 名女性,2 名男性),年龄在 48-69 岁之间(中位数:57 岁)。本研究评估了 11 项非心脏手术,如头颈部恶性肿瘤经动脉输注化疗(4 例)、内脏动脉瘤栓塞术(2 例)、肾血管肌脂肪瘤栓塞术(2 例)、经皮腔内肾血管成形术(1 例)、支气管动脉栓塞术(1 例)和诊断性血管造影术(1 例)。导管鞘的尺寸为 4-6 French。使用的导管分别有九种尖端形状。只有两例宫颈手术使用了反向曲线导管。技术成功率为 91%(10/11)。在 11 例手术中,只有 1 例(支气管动脉栓塞)需要转为经股动脉入路。经桡动脉远端入路手术未出现并发症。治疗后的超声评估显示,所有患者的桡动脉都是通畅的:结果表明,经桡动脉远端入路使用市售导管是可行的,而且对各种非心脏介入治疗是安全的。
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