8477 Uterine Artery Embolization Via Transradial Versus Transfemoral Arterial Access: Technical and Clinical Results

Abstract

<h3>Study Objective</h3> To compare the technical and clinical outcomes of transradial (TRA) versus transfemoral (TFA) access in patients undergoing uterine artery embolization (UAE) for symptomatic uterine fibroids. <h3>Design</h3> Retrospective study. <h3>Setting</h3> Single institution, tertiary care center in Northeastern USA from 2015-2021. <h3>Patients or Participants</h3> Patients undergoing uterine artery embolization at our institution (n=43) were included. <h3>Interventions</h3> Uterine artery embolization via transradial or transfemoral access. <h3>Measurements and Main Results</h3> A retrospective analysis was conducted for 2 cohorts: 15 procedures were performed via TRA and 28 procedures were performed via TFA. Median age was 45 years in both groups and procedure type was determined based off of surgeon and patient preference. Indications for embolization included: menorrhagia (n=33), dysmenorrhea (n=9), anemia (n=15), and bulk symptoms (n=34). Patients with malignancy of the uterus or ovaries, infection, renal failure, and desire for future fertility were excluded. Five vascular surgeons performed all procedures at one institution. Technical success, pain improvement, operative time and length of stay were assessed. Technical success, defined as successful delivery of embolic agent into target artery, was achieved for all patients in both cohorts. Mean procedure time was 166 minutes in TRA group and 140 min in TFA group. There was no significant difference in subjective pain changes at post-operative clinic visits and length of stay between groups. <h3>Conclusion</h3> While both TRA and TFA access achieved equal technical success, TRA access did come with increased operative time. As major drivers of increasing use of TRA include earlier time to ambulation after the procedure, earlier discharge from the hospital, and higher patient satisfaction, these outcomes warrant future investigation. Nonetheless, transradial access in uterine artery embolization represents a safe and feasible minimally invasive approach with a comparable safety profile to transfemoral access in the management of symptomatic uterine fibroids.