Abstract
Abstract Purpose The purpose of this pilot study was to evaluate the acute success and complication rate of the distal radial artery access for femoral artery intervention. Methods and results The clinical and angiographic data of 195 consecutive cases with symptomatic superficial femoral stenosis, treated via distal radial (DR) or proximal radial (PR) access using 6F sheathless guiding between 2014 and 2018, were evaluated in a pilot study. Secondary access was achieved through the pedal artery. Primary endpoint: major adverse events (MAE), rate of major and minor access site complications. Secondary endpoints: angiographic outcome, procedural factors, cross-over rate to femoral access site, and duration of hospitalization. Overall technical success was achieved in 186 patients (95.4%) with 25/26 (96.1%) success in DR and 161/169 (95.2%) success in PR group (ns). The cross over rate to femoral access site was 3.8% in DR and 4.7% in PR group (ns), while dual (transradial and transpedal) access was used in 9/26 (34.6%) patients in DR and 39/169 (23%) patients in PR group (p<0.05). Stent implantation was necessary in 8/26 (30.7%) cases in DR and in 42/169 (24.8%) cases in PR group (ns). CTO recanalization was performed in the DR and PR group with 94.1% (16/17) and 92.6% (79/81) technical success rate. The mean contrast consumption, fluoroscopy time and procedure time was in the DR and PR group was: 93.4 [78–108]ml vs 120 [108–131]ml, 662 [501–822]vs 769 [671–866]min, and 33.4 [27–39]vs 36.5 [32–40]min (ns), respectively. The rate of access site complications in the DR and PR group was 0% and 4.7% (0% major, 4.7% minor) (p p<0.001), respectively. The cumulative incidence of MAE at 3 months in the DR and PR group was 3.8% vs 10.6% (p<0.05). Conclusion Femoral artery intervention can be safely and effectively performed using distal transradial access and distal radial access is associated with lower access site complications.
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