ABSTRACT
PURPOSE: The generally preferred vascular access for neurointerventional procedures is the transfemoral approach (TFA). In complicated cases such as patients with aortic diseases or tortuous vessels, transradial or transbrachial approaches (TRA or TBA) could be good alternatives. The purpose of this study is to review a single medical center experience using the alternative accesses. MATERIALS AND METHODS: We reviewed the medical records of 30 TRA and 10 TBA cases among 2,073 cases treated between January 2010 and July 2013. We reviewed and analyzed the frequency of TRA and TBA, the reason the operator had chosen the TRA or TBA, the category of the procedure, caliber of the sheath, the success rate, and the complications rates. RESULTS: The most common reason the non-TFA route was chosen was due to the patient's tortuous vascular system (n=24, 60%). The most common category of intervention was balloon angioplasty and/or stent placement (n=18, 45%). The largest caliber of the introducing sheath was 6 Fr in TRA and 7 Fr in TBA. Procedural success was achieved in 37 cases (success rate: 92.5%), and in three cases it failed. Six patients with complications were reported. Among them, four cases of minor complications (10%) occurred. There was no serious complication directly related to the access problem. CONCLUSION: Both TRA and TBA can be good alternative access routes when TFA is not appropriate in various neurointervential procedures.
Subject(s)
Humans , Angioplasty, Balloon , Aortic Diseases , Endovascular Procedures , Medical Records , StentsABSTRACT
Objective: To access the application of percutaneous coronary angioplasty via radial artery in treatment of acute myocardial infarction. Methods: Totally 107 patients with acute myocardial infarction (AMI) were included in this study. Transradial approach (group A) percutaneous coronary intervention (PCI) was used in 56 patients and the transfemoral approach (group B) PCI was used in 51 patients. The successful rates of puncture procedure and PCI, time of artery carmulation, the carmulation to balloon inflation times, the total procedure time, and local puncture complications were compared between the 2 groups. Results: The successful rates of puncture procedure were IN% in both groups and their successful rates of PCI were higher than 96%. The time of artery carmulation, the cannulation to balloon inflation time, and the total procedure time were similar in group A and group B ([2.93±0.42] min vs [3.07±0.54] min, P=0.14; [17.23±3.47] min vs [16.81±4.86] min, P=0.61; [47.04±7.53] min vs [48.74±6.22] min, P=0.21, respectively). The incidence of bleeding and edema around puncture sites in group B was higher than that in group A (5/51 vs 0/56, P=0.016 4); the vagal reaction rate in group B was higher than that in group B (4/51 vs 0/56, P=0.032 7). Conclusion: Transradial access is a safe and feasible technique for performing percutaneous coronary intervention in treatment of acute myocardial infarction; it can decrease major bleeding complications.
ABSTRACT
0.05).Follow-up coronary angiography was more frequently performed in group A than in group B.Conclusion In patients with acute myocardial infarction treated with primary percutaneous coronary intervention,the transradial approach is a safe and feasible technique.With the higher rate of follow-up angiography,it was found that the incidence of MACE at 1-month follow-up and 6-month follow-up using the transradial approach was similar to transfemoral approach.Therefore,the transradial approach is expected to become the substitute approach for treatment in AMI patients.