E-178 A radial first approach for diagnostic cerebral angiography: comparison of procedure and safety parameters for transradial and transfemoral access

Abstract

Background and Purpose Transradial diagnostic cerebral angiography is slowly gaining acceptance due to significant safety advantages over transfemoral angiography, but there is limited data comparing other procedure parameters between the two techniques. We document the impact of adopting a ‘radial first’ diagnostic cerebral angiography in a busy multihospital setting. Methods Six hundred forty-five consecutive patients referred for diagnostic 4-vessel cerebral angiography were considered for primary radial access over a three-year period. Radial access procedure data were analyzed retrospectively using prospectively maintained data. Radial procedure parameters were compared to a cohort of two hundred fifty consecutive transfemoral cerebral angiograms from the preceding year. Results Five hundred forty-five patients of 645 patients (84%) underwent primary radial access for diagnostic cerebral angiography (460 proximal radial, 85 distal radial). Compared to the femoral standard, radial cohort procedure duration/vessel and fluoroscopy time/vessel were significantly longer, but the fluoroscopy dose/vessel was statistically similar. The radial contrast dose/vessel was significantly less than the femoral standard. With experience, radial procedure duration/vessel and fluoroscopy dose/vessel became significantly better than the femoral standard and the fluoroscopy time/vessel become statistically similar at the p=0.05 level. The radial to femoral conversion rate was 3.3%. There were no major periprocedural complications in the radial group. Conclusions With experience, transradial cerebral angiography became better than or equal to the femoral standard in all procedure parameters with fewer complications and equal diagnostic utility. These findings add additional support for expanding use of transradial access for routine cerebral angiography. Disclosures T. Peebles: 2; C; Terumo Medical. 4; C; RIST Neurovascular. D. Conners: None. A. Peebles: None. J. Garland: None.