Transradial versus Transfemoral Approach for Neuroendovascular Procedures: A Survey of Patient Preferences and Perspectives

Abstract

Studies about the transradial technique and experience with this approach abound in the neurointerventional literature, but studies focusing on patient perspectives and preferences with respect to transfemoral or transradial access are scarce. Patients from our center who underwent both transradial and transfemoral approaches for diagnostic and interventional cerebral angiograms on distinct occasions between January 2016 and January 2021 were identified and interviewed by phone regarding their experience with these access approaches. The first question was regarding the choice for an eventual next procedure (radial, femoral, or no preference). The second question addressed reasons (pain, bruising, complications, recovery time, mobility, failure of one approach, and comfort associated with puncture of the respective area). Forty-four patients were interviewed. Thirty-one (70.4%) preferred radial, 9 (20.5%) preferred femoral, and 4 (9.1%) had no preference. Most frequent reasons for radial preference were recovery time (67.7%), bruising (51.6%), and pain (48.4%). Most frequent reasons in femoral preference were pain (55.6%), mobility (33.3%), and failure of the other approach (33.3%). Recovery time (67.7% vs. 22.2%; P= 0.023) and comfort of puncturing the area (45.2% vs. 0%; P= 0.015) were significantly more frequent reasons for radial preference, whereas failure of the other approach (0% vs. 33.3%; P= 0.008) was a significantly more frequent reason for femoral preference. Most patients preferred the transradial approach. Evaluating the reasons behind their preference can help operators to better understand patient perspectives and improve quality of care.