Transradial Intervention of Iliac and Superficial Femoral Artery Disease is Feasible

Abstract

Percutaneous intervention of iliac artery (IA) and superficial femoral artery (SFA) disease is often performed via ipsilateral or contralateral femoral access. However, this approach may be difficult in patients with severe iliac or common femoral artery atherosclerosis, morbid obesity, or conditions prohibiting prolonged bed rest. Percutaneous transradial coronary intervention has gained popularity due to the low frequency of access site complications, early ambulation, and perhaps cost savings with early discharge. Transradial intervention (TRI) of IA and SFA disease has been previously described only in anecdotal case reports. Out of 159 patients who underwent IA and SFA intervention, 15 had their intervention attempted via the radial artery. TRI was attempted at the operator's discretion for one of the following reasons: absent femoral pulses, severe bilateral IA disease, obesity, or conditions prohibiting prolonged supine rest. Clinical and procedural characteristics were collected retrospectively. Fourteen patients (93%) had successful intervention completed through the transradial approach. One patient needing an intervention of the distal SFA was converted to contralateral femoral approach because of the inadequate stent shaft length. Eighteen IA lesions and six SFA lesions were treated successfully with a good final angiographic result via a 6 FR radial access system. The ankle brachial index improved from a mean of 0.66 to 0.93. None of the patients had any procedural or access site-related complications. TRI is a feasible and safe alternative for percutaneous treatment of IA and SFA disease in carefully selected patients.