166 Trans-radial Versus Trans-femoral Access Routes for Diagnostic Cerebral Angiograms: A Large Single-Center Comparative Cost-analysis Study

Abstract

INTRODUCTION: Recently, the trans-radial approach has become a common alternative given its safety profile and increased patient satisfaction compared to the transfemoral route. Both routes are associated with their respective associated costs and differences typically emerge based on patients’ anatomy, operator expertise, and occurrence of complications. METHODS: This a retrospective single-center study of 926 elective diagnostic angiograms performed between December 2019 and March 2022. RESULTS: The study comprised of 314 and 612 angiograms done through the TF and TR routes respectively. Female patients were significantly higher in the TF cohort (79.3% vs 67.8%, p < .001), and most other demographic characteristics and baseline modified Rankin Scale score were comparable between both cohorts. The overall cost of patients utilizing the TR route was comparable to that of the TF route ($12591.8 ± 19128 vs $12789.5 ± 18424, p = .88). However, the median cost of catheters was significantly higher in TR group ($55.2 vs $12.4, p = .03), while the median cost of closure devices ($87 vs $20.2 p < .001), and sheaths ($44.6 ± 11.3 vs $41.1 ± 3.1, p < .001) was significantly higher in the TF group. CONCLUSIONS: Overall, our study shows that the TR approach can be less a less expensive option for patients undergoing diagnostic cerebral angiograms, especially if complications occur. Future studies can corroborate our findings and potentially lead to the adoption of TR as a low-cost, efficient, gold-standard technique for cerebral angiography.