Authors (including presenting author) :
Chu YLE(1), Ng YY(1), Chong YM(1), Lau HT(1), ACO Tsang(2), M Tse(3), Lui WM(2), R Lee(1)
Affiliation :
(1)Department of Radiology, Queen Mary Hospital, (2) Department of Neurosurgery, Queen Mary Hospital, (3)Department of Medicine, Queen Mary Hospital
Introduction :
In the last 2 decades we have seen a shift from trans-femoral access (TFA) to trans-radial access(TRA) in the field of interventional cardiology. This transition is primarily fuelled by compelling evidence from multiple randomised trials demonstrating an overwhelming superiority of TRA over TFA in patient safety, decreased length of stay, reduced hospital costs, and patient preference.
Recent evidence from interventional neuroradiology literature suggests the same benefits of TRA in interventional cardiology can be applied to neurointervention. Despite this, the vast majority of cerebral angiography is still performed via trans-femoral approach at present time.
Here we share our institution’s experience in the transition from the traditional TFA to a ‘radial-first’ approach for diagnostic cerebral angiography.
Objectives :
To report a single center's experience concerning the feasibility, efficacy, and safety of TRA in diagnostic cerebral angiography.
Methodology :
59 patients underwent attempted trans-radial diagnostic cerebral angiographies between September 2020 and August 2021. Data were collected regarding patient demographics, procedural metrics, complications, and procedural duration.
Result & Outcome :
58 out of 59 patients (98.3%) underwent successful trans-radial cerebral angiography. Satisfactory diagnostic information were yielded in all of the procedures that were successfully performed via TRA (58/58). Femoral crossover was reported in 1 case in which catheter navigation was precluded by the tortuosity of the radial artery. Mean procedural duration was 43.2 minutes.
1 patient reported transient mild hand weakness consequential to partial radial artery occlusion following intervention. This was spontaneously resolved in 2 weeks .The overall incidence of complication rate for TRA was low (1/59, 1.6%). Severe procedural-related complications such as permanent functional disability of hand, pseudoaneurysm, arterial dissection or stroke were not demonstrated. In addition, 37 out of 43 patients were able to leave the hospital on the same day of the procedure following their elective hospital admission.
Our experience shows that trans-radial cerebral angiography is safe and feasible with the potential for improved patient mobility in the post-procedural period as well as reduced hospital costs.
