Evaluation of repeat distal transradial access in the anatomic snuffbox
PurposeThere is increasing interest in the distal radial artery in the anatomic snuffbox as an alternative arterial access point, but the durability of the distal radial artery to support repetitive accesses over multiple procedures is not well established. The purpose of this study was therefore to...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Galenos Publishing House
2021-09-01
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| Series: | Diagnostic and Interventional Radiology |
| Online Access: |
http://www.dirjournal.org/archives/archive-detail/article-preview/evaluation-of-repeat-distal-transradial-access-in-/53872
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| _version_ | 1827823556671569920 |
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| author | James Ronald Nicholas Durocher Jonathan G. Martin Tony P. Smith Charles Y. Kim Alan A. Sag |
| author_facet | James Ronald Nicholas Durocher Jonathan G. Martin Tony P. Smith Charles Y. Kim Alan A. Sag |
| author_sort | James Ronald |
| collection | DOAJ |
| description | PurposeThere is increasing interest in the distal radial artery in the anatomic snuffbox as an alternative arterial access point, but the durability of the distal radial artery to support repetitive accesses over multiple procedures is not well established. The purpose of this study was therefore to evaluate success rates for repeated left-sided distal transradial access (ldTRA) in the anatomic snuffbox.MethodsIn this single institution retrospective study, all patients undergoing radioembolization treatments from January 1st, 2019 to May 1st, 2020 were prospectively evaluated for ldTRA. ldTRA was performed by 15 different operators. Exclusion criteria were a left radiocephalic hemodialysis fistula, inability to properly position the arm, Barbeau D waveform, or failed prior ldTRA due to tortuosity. Barbeau patterns, arterial sizes, and success rates at the first, second, and third ldTRA were compared.ResultsFifty patients were evaluated for ldTRA and 44, 39, and 10 underwent one, two, and three ldTRA attempts for a total of 93 procedures. There was no significant change in Barbeau patterns between the first and second (p = 0.13) or first and third (p = 1.0) ldTRA. There was no significant change in artery size between the first (mean, 2.3 mm; range, 1.5–3.4 mm) and second (mean, 2.3 mm; range, 1.6–3.3 mm) (p = 0.59) and first and third (mean, 2.4 mm; range, 1.9–3.3) (p = 0.45) ldTRA. The success rate was not significantly different between the first (93%, 41/44, 95% CI 81%–99%), second (95%, 37/39, 95% CI 83%–99%), and third (100%, 10/10, 95% CI 69%–100%) procedure (p = 1.0). The asymptomatic occlusion rate was 4.1% (2/49, 95% CI 0%–14%), and subsequent ldTRA was successfully completed in both patients with occlusions. There were no hemorrhagic or ischemic complications.ConclusionSuccess rates are indistinguishable among first, second, and third time ldTRA suggesting that this is a durable access point. |
| first_indexed | 2024-03-12T02:12:25Z |
| format | Article |
| id | doaj.art-ac3ef774a2264d7fa02c8af291ff1d3a |
| institution | Directory Open Access Journal |
| issn | 1305-3825 1305-3612 |
| language | English |
| last_indexed | 2024-03-12T02:12:25Z |
| publishDate | 2021-09-01 |
| publisher | Galenos Publishing House |
| record_format | Article |
| series | Diagnostic and Interventional Radiology |
| spelling | doaj.art-ac3ef774a2264d7fa02c8af291ff1d3a2023-09-06T12:18:30ZengGalenos Publishing HouseDiagnostic and Interventional Radiology1305-38251305-36122021-09-0127563964310.5152/dir.2021.2037513049054Evaluation of repeat distal transradial access in the anatomic snuffboxJames Ronald0Nicholas Durocher1Jonathan G. Martin2Tony P. Smith3Charles Y. Kim4Alan A. Sag5 Division of Vascular & Interventional Radiology, Department of Radiology, Duke University Medical Center, Durham, North Carolina, USA Division of Vascular & Interventional Radiology, Department of Radiology, Duke University Medical Center, Durham, North Carolina, USA Division of Vascular & Interventional Radiology, Department of Radiology, Duke University Medical Center, Durham, North Carolina, USA Division of Vascular & Interventional Radiology, Department of Radiology, Duke University Medical Center, Durham, North Carolina, USA Division of Vascular & Interventional Radiology, Department of Radiology, Duke University Medical Center, Durham, North Carolina, USA Division of Vascular & Interventional Radiology, Department of Radiology, Duke University Medical Center, Durham, North Carolina, USA PurposeThere is increasing interest in the distal radial artery in the anatomic snuffbox as an alternative arterial access point, but the durability of the distal radial artery to support repetitive accesses over multiple procedures is not well established. The purpose of this study was therefore to evaluate success rates for repeated left-sided distal transradial access (ldTRA) in the anatomic snuffbox.MethodsIn this single institution retrospective study, all patients undergoing radioembolization treatments from January 1st, 2019 to May 1st, 2020 were prospectively evaluated for ldTRA. ldTRA was performed by 15 different operators. Exclusion criteria were a left radiocephalic hemodialysis fistula, inability to properly position the arm, Barbeau D waveform, or failed prior ldTRA due to tortuosity. Barbeau patterns, arterial sizes, and success rates at the first, second, and third ldTRA were compared.ResultsFifty patients were evaluated for ldTRA and 44, 39, and 10 underwent one, two, and three ldTRA attempts for a total of 93 procedures. There was no significant change in Barbeau patterns between the first and second (p = 0.13) or first and third (p = 1.0) ldTRA. There was no significant change in artery size between the first (mean, 2.3 mm; range, 1.5–3.4 mm) and second (mean, 2.3 mm; range, 1.6–3.3 mm) (p = 0.59) and first and third (mean, 2.4 mm; range, 1.9–3.3) (p = 0.45) ldTRA. The success rate was not significantly different between the first (93%, 41/44, 95% CI 81%–99%), second (95%, 37/39, 95% CI 83%–99%), and third (100%, 10/10, 95% CI 69%–100%) procedure (p = 1.0). The asymptomatic occlusion rate was 4.1% (2/49, 95% CI 0%–14%), and subsequent ldTRA was successfully completed in both patients with occlusions. There were no hemorrhagic or ischemic complications.ConclusionSuccess rates are indistinguishable among first, second, and third time ldTRA suggesting that this is a durable access point. http://www.dirjournal.org/archives/archive-detail/article-preview/evaluation-of-repeat-distal-transradial-access-in-/53872 |
| spellingShingle | James Ronald Nicholas Durocher Jonathan G. Martin Tony P. Smith Charles Y. Kim Alan A. Sag Evaluation of repeat distal transradial access in the anatomic snuffbox Diagnostic and Interventional Radiology |
| title | Evaluation of repeat distal transradial access in the anatomic snuffbox |
| title_full | Evaluation of repeat distal transradial access in the anatomic snuffbox |
| title_fullStr | Evaluation of repeat distal transradial access in the anatomic snuffbox |
| title_full_unstemmed | Evaluation of repeat distal transradial access in the anatomic snuffbox |
| title_short | Evaluation of repeat distal transradial access in the anatomic snuffbox |
| title_sort | evaluation of repeat distal transradial access in the anatomic snuffbox |
| url |
http://www.dirjournal.org/archives/archive-detail/article-preview/evaluation-of-repeat-distal-transradial-access-in-/53872
|
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