scholarly journals Coronary Angiography Safety between Transradial and Transfemoral Access

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Santosh Kumar Sinha ◽  
Vikas Mishra ◽  
Nasar Afdaali ◽  
Mukesh Jitendra Jha ◽  
Ashutosh Kumar ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Vascular Complications ◽  
Fluoroscopy Time ◽  
Transfemoral Approach ◽  
Transradial Approach ◽  
Dose Area Product ◽  
Medical College ◽  
Coronary Catheterization ◽  
Standard Population ◽  
Area Product

Background and Aim. The aim of study was to evaluate safety, feasibility, and procedural variables of transradial approach compared with transfemoral approach in a standard population of patients undergoing coronary catheterization as one of the major criticisms of the transradial approach is that it takes longer overall procedure and fluoroscopy time, thereby causing more radiation exposure. Method. Between January 2015 and December 2015, a total of 1,997 patients in LPS Institute of Cardiology, GSVM Medical College, Kanpur, UP, India, undergoing coronary catheterization were randomly assigned to the transradial or transfemoral approach. Result. Successful catheterization was achieved in 1045 of 1076 patients (97.1%) in the transradial group and in 918 of 921 patients (99.7%) in the transfemoral group (p=0.001). Comparing the transradial and transfemoral approaches, fluoroscopy time (2.46±1.22 versus 2.83±1.31 min; p=0.32), procedure time (8.89±2.72 versus 9.33±2.82 min; p=0.56), contrast volume (67.52±22.54 versus 71.63±25.41 mL; p=0.32), radiation dose as dose area product (24.2±4.21 versus 22.3±3.46 Gycm2; p=0.43), and postprocedural rise of serum creatinine (6±4.5% versus 8±2.6%; p=0.41) were not significantly different while vascular access site complications were significantly lower in transradial group than transfemoral group (3.9% versus 7.6%; p=0.04). Conclusion. The present study shows that transradial access for coronary angiography is safe among patients compared to transfemoral access with lower rate of local vascular complications.

scholarly journals Comparison of In-Hospital Outcomes of ST Elevation Myocardial Infarction in Patients Undergoing Transradial and Transfemoral Primary Percutaneous Coronary Intervention

2019 ◽  
Vol 11 (2) ◽  
pp. 98-104
Author(s):  
Fahdia Afroz ◽  
Mir Jamal Uddin ◽  
Md Khalquzzaman ◽  
Mohammad Ullah ◽  
Mohammad Khalilur Rahman Siddiqui ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Vascular Complications ◽  
Coronary Intervention ◽  
Adverse Outcomes ◽  
Transfemoral Approach ◽  
Transradial Approach ◽  
Group I ◽  
Percutaneous Coronary ◽  
St Elevation ◽  
Group Ii

Background: Primary percutaneous coronary intervention (PPCI) has been performed traditionally by using femoral approach. Transradial approach has become increasingly popular as it is likely to be less complicating, more comfortable and relatively cost effective having mortality and morbidity benefits. The aim of the study was to compare the in-hospital outcomes of transradial PPCI with that of transfemoral route. Methods: A total of 80 patients with ST elevation myocardial infarction (STEMI) who underwent PPCI were enrolled in the study. Patients were divided in two groups. Group-I: transradial PPCI; and Group-II: transfemoral PPCI. All patients were followed up during the period of hospital stay and adverse outcomes were observed and compared between the groups. Results: The result showed that bleeding took place in 2.5% patient of Group-I and 15% patients of Group- II. Vascular complications occurred in 2.5% and 12.5% patients of Group-I and Group-II, respectively. In Group-II, 7.5% patients died with none in Group-I. In Group-II, 37.5% patients experienced some sort of adverse outcomes whereas only 15% of the patients of Group-I did have such experiences (p<0.05). Bleeding and vascular complications were significantly more in Group-II (p<0.05). The mean hospital stay time was significantly lower in Group-I (p<0.001). Conclusions: Transradial PPCI is safer than transfemoral approach in respect of procedural and post procedural complications including bleeding, vascular complications and mortality. So, transradial approach may be an attractive alternative to conventional transfemoral approach and can be practiced routinely for PPCI. Cardiovasc. j. 2019; 11(2): 98-104

scholarly journals Initial Experience Using the Transradial Approach for Endovascular Treatment of Vascular Pathologies: Safety and Feasibility

2022 ◽  
Author(s):  
Giancarlo Saal-Zapata ◽  
Rodolfo Rodríguez-Varela
Keyword(s):  
Endovascular Treatment ◽  
Vascular Malformations ◽  
Superficial Temporal Artery ◽  
Artery Aneurysm ◽  
Temporal Artery ◽  
Fluoroscopy Time ◽  
Initial Experience ◽  
Transfemoral Approach ◽  
Transradial Approach ◽  
The Right

Abstract Background Endovascular treatment of vascular pathologies through the transradial approach has been increasingly used and has demonstrated a low rate of complications. Objective To report our initial experience in the endovascular treatment of cerebrovascular diseases with the transradial approach and to determine its safety and feasibility. Methods Consecutive patients who underwent the transradial approach for endovascular treatment of aneurysms and vascular malformations were reviewed at a single institution. Technical success, fluoroscopy time, and access-related complications were analyzed. Results Eight patients underwent endovascular treatment with the transradial approach. One arteriovenous fistula, one superficial temporal artery aneurysm, three arteriovenous malformations, and four aneurysms were treated successfully. The radial artery was successfully approached and a 6-F sheath was used in all the cases. Navigation of guiding catheters (5 and 6 F) was done without complications. The most commonly approached artery was the right internal carotid artery, followed by the right vertebral artery. Postoperative vasospasm was identified in three patients. Mean fluoroscopy time was 34.7 minutes. Conversion to transfemoral approach was not required. No postoperative complications were reported. Conclusions In our initial experience, the transradial approach is a safe and feasible alternative for the endovascular treatment of cerebrovascular pathologies.

scholarly journals Radiation Dose and Fluoroscopy Time of Endovascular Treatment in Patients with Intracranial Lateral Dural Arteriovenous Fistulae

2020 ◽  
Author(s):  
Robert Forbrig ◽  
Robert Stahl ◽  
Lucas L. Geyer ◽  
Yigit Ozpeynirci ◽  
Thomas Liebig ◽  
...  
Keyword(s):  
Low Dose ◽  
Endovascular Embolization ◽  
Fluoroscopy Time ◽  
Low Grade ◽  
Endovascular Technique ◽  
Dose Area Product ◽  
Single Center Study ◽  
Life Threatening ◽  
Area Product ◽  
Dosimetry Data

Abstract Purpose Intracranial lateral dural arteriovenous fistula (LDAVF) represents a specific subtype of cerebrovascular fistulae, harboring a potentially life-threatening risk of brain hemorrhage. Fluoroscopically guided endovascular embolization is the therapeutic gold standard. We provide detailed dosimetry data to suggest novel diagnostic reference levels (DRL). Methods Retrospective single-center study of LDAVFs treated between January 2014 and December 2019. Regarding dosimetry, the dose area product (DAP) and fluoroscopy time were analyzed for the following variables: Cognard scale grade, endovascular technique, angiographic outcome, and digital subtraction angiography (DSA) protocol. Results A total of 70 patients (19 female, median age 65 years) were included. Total median values for DAP and fluoroscopy time were 325 Gy cm2 (25%/75% percentile: 245/414 Gy cm2) and 110 min (68/142min), respectively. Neither median DAP nor fluoroscopy time were significantly different when comparing low-grade with high-grade LDAVF (Cognard I + IIa versus IIb–V; p > 0.05, each). Transvenous coil embolization yielded the lowest dosimetry values, with significantly lower median values when compared to a combined transarterial/transvenous technique (DAP 290 Gy cm2 versus 388 Gy cm2, p = 0.031; fluoroscopy time 85 min versus 170 min, p = 0.016). A significant positive correlation was found between number of arterial feeders treated by liquid embolization and both DAP (rs = 0.367; p = 0.010) and fluoroscopy time (rs = 0.295; p = 0.040). Complete LDAVF occlusion was associated with transvenous coiling (p = 0.001). A low-dose DSA protocol yielded a 20% reduction of DAP (p = 0.021). Conclusion This LDAVF study suggests several local DRLs which varied substantially dependent on the endovascular technique and DSA protocol.

Outcomes of Radial Versus Femoral Approach in Patients with St Segment Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention

2021 ◽  
Vol 23 (Supplement_D) ◽  
Author(s):  
Emad Torkey ◽  
Mohamed Sanhoury ◽  
Mohammad Sadaka ◽  
Amr Zaki
Keyword(s):  
Hospital Stay ◽  
Anticoagulation Therapy ◽  
Vascular Complications ◽  
University Hospital ◽  
P Value ◽  
Access Site ◽  
Transfemoral Approach ◽  
Femoral Access ◽  
Transradial Approach ◽  
Procedural Time

Abstract Aim of the work To compare transradial and transfemoral approaches in 1ry and rescue PCI for STEMI. Methods This prospective observational study was done at Alexandria University Hospital and International Cardiac Center from January 2020 to August 2020 by recruiting every patient had met our inclusion criteria (the third universal definition of MI) admitted to the coronary care unit after doing primary or rescue PCI 200 patients were involved. Exclusion criteria were (Thrombophilia and thrombocytopenia, known hematological abnormalities, and patients with known sever peripheral vascular disease. Randomization made by a computer-generated program into two equal parallel groups that were randomly assigned to either Radial access approach or femoral access approach for primary or rescue PCI. Chest pain to time of first medical contact (FMC), and the procedural time were computed. Coronary angiography and PCI procedure were described including materials used and the intra-procedure complications. MACE (Major Adverse Cardiac Events) or other hemodynamic complications were documented. All the patients were contacted for follow up to 6 months after the procedure by interviewing with the patients via telephone or the responsible physician to determine the outcomes procedure. Results The distribution of demographic variables and risk factors were similar among 200 patients in the radial and femoral groups. There had been significant differences between the groups concerning the primary end point MACE after 6 months in favor of radial group patients with p value (0.004), there was significant deference between the two studied groups concerning the total bleeding complication with higher risk in femoral group 11% compared to radial group 3% with P value (0.02). Despite the nearly equal mean time from pain to FMC (9.01 hours in radial group and 9.2 hours in femoral group), the total procedural time was significantly longer in radial group compared to femoral group with (p value 0.037). However the rate of non-culprit vessel revascularsation was significantly higher in radial group 17% compared to 6% in femoral group with p value of (0.015). In-hospital stay was significantly shorter in the radial group patients P value (0.02). Conclusion Transradial approach is safe, and effective with a high procedural success rate as the transfemoral approach but with lower risk for bleeding vascular complications and other access site complications as hematoma especially for patients where aggressive antiplatelet and anticoagulation therapy is needed, or patients who are expected to suffer from access site complications as those who need rescue PCI. Transradial approach has major additional advantages of decreasing the incidence of MACE compared to transfemoral approach. Transradial approach has another advantages of decreasing the in hospital stay.

Analysis of Radiation Exposure during Endovascular Aneurysm Repair

2012 ◽  
Vol 78 (10) ◽  
pp. 1029-1032 ◽  
Author(s):  
Michael Butler ◽  
Madhukar S. Patel ◽  
Samuel E. Wilson
Keyword(s):  
Radiation Exposure ◽  
Endovascular Aneurysm Repair ◽  
Abdominal Aortic Aneurysm Repair ◽  
Fluoroscopy Time ◽  
Potential Hazard ◽  
Dose Area Product ◽  
Contrast Volume ◽  
Using Data ◽  
Area Product ◽  
Aneurysm Repair

Endovascular aneurysm repair (EVAR) is now the preferred procedure for abdominal aortic aneurysm repair. As a result of the need for fluoroscopy during EVAR, radiation exposure is a potential hazard. We studied the quantity of radiation delivered during EVAR to identify risks for excessive exposure. Fluoroscopy time, contrast volume used, and procedural details were recorded prospectively during EVARs. Using data collected from similar EVARs, an equation was derived to calculate approximate dose-area product (DAP) from fluoroscopy time. DAP values were then compared between procedures in which a relevant postdeployment procedure (PDP) was necessary intraoperatively with those without. Clinical data on 17 patients were collected. The mean age of patients was 68 (±9) years. Fluoroscopy times and approximate DAP values were found to be significantly higher in the seven patients with a PDP compared with the 10 patients without an intraoperative PDP (31.2 [±9.6] vs 22.7 [±6.0] minutes, P = 0.033 and 537 [±165] vs 390 [±103] Gy-cm2, P = 0.033, respectively). The average amount of contrast volume used was not significantly different between groups. Radiation emitted during EVARs with PDPs was significantly greater relative to those without PDPs. Device design and operators should thus aim to decrease PDPs and to minimize fluoroscopy time.

Ultrasonic assessment of vascular complications in coronary angiography and angioplasty after transradial approach

1999 ◽  
Vol 83 (2) ◽  
pp. 180-186 ◽  
Author(s):  
Shunichi Nagai ◽  
Shigeru Abe ◽  
Takayuki Sato ◽  
Koji Hozawa ◽  
Koichi Yuki ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Vascular Complications ◽  
Transradial Approach ◽  
Ultrasonic Assessment
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