Authors (including presenting author) :
Ng YY(1), Chong YM (1), Chu YLE(1) ,R Lee(1)
Affiliation :
(1) Department of Radiology, Queen Mary Hospital
Introduction :
Catheter-based cerebral angiography is an important invasive procedure to examine cerebral vasculature. Traditionally, the procedure was performed via femoral access. In recent times , there is a shift from transfemoral to transradial approach for this procedure in the international neurointerventional community. This transition was fueled by strong evidence of lower complication rates, earlier ambulation and reduced hospital costs. We describe our findings from a retrospective survey of patients' preferences for transradial (TRA) and transfemoral( TRA) access in catheter based cerebral angiography.
Objectives :
To determine patients’ preference for transradial access (TRA) versus transfemoral access (TFA) after they underwent catheter-based cerebral angiography via both routes.
Methodology :
This is a single center, consecutive survey for all patients who had undergone successful catheter cerebral angiography via both transfemoral and transradial approaches. Our center has adopted a ‘radial-first’ approach for cerebral angiography since September 2020. We retrospectively analyzed our institutional database of cerebral angiographies performed via trans-radial route between September 2020 and December 2021. Past medical and procedural records were reviewed via electronic patient record (EPR). A total of 26 patients were found to have undergone both TRA and TFA cerebral angiography and so met the inclusion criteria. Survey were conducted via phone interview to gain a better understanding of the patients' viewpoints and experiences with these two approaches.
Result & Outcome :
The survey was completed by 20 patients who had radial access cerebral angiography following a previous femoral access cerebral angiography (20/26, 77 % ).
No major complications including wound infection and symptomatic occlusion or injury of the access vessels were encountered in any cases.
Because TRA did not necessitate groin exposure, 16 of the 20 patients in this survey (80%) felt less embarrassed with it.
9 patients (45%) reported the overall perceived pain during the procedure was less in TRA compared to TFA, whilst 3 patients (15%) reported less pain with TFA.
The radial compression band haemostasis is more satisfactory to 14 patients (70 %).In postprocedural care, 15 (75%) regarded TRA to be superior to RFA.
16 patients (80%) stated that they preferred TRA over TFA and that if they needed another operation in the future, they would choose TRA.
In our single-center retrospective survey, patients showed a substantial preference for radial artery access (TRA)over femoral artery (TFA) access in catheter-based cerebral angiography. With TRA, patients generally experienced less procedural pain and earlier ambulation after procedure. In this age of patient-centered care, a ‘radial-first’ approach for catheter cerebral angiography should be considered.
