Radial access for peripheral artery interventions associated with favorable safety profiles
A new study published today in the Journal of the Society for Cardiovascular Angiography & Interventions (JSCAI) explores the safety and efficacy of using radial access (RA) for peripheral artery interventions. The study, conducted by a team of researchers from prominent medical centers, aimed at examining evaluating the safety and feasibility of RA for complex endovascular lower extremity interventions.
Peripheral artery interventions, such as angioplasty and stenting, are commonly performed to treat vascular conditions that obstruct blood flow to the lower extremities. Traditionally, these procedures have been performed using a femoral artery access approach. However, in recent years, there has been increasing interest in using radial access, which involves accessing the arteries of the wrist or forearm, as an alternative approach.
From June 2020 to June 2021, 120 patients at 8 U.S. centers were enrolled. Mean age was 68.7 years and 31.7% were women. The 224 lesions treated were in iliac (12.9%), femoro-popliteal (55.3%), isolated popliteal (11.9%) and tibial (19.5%) vessels. The primary efficacy endpoint was achieved in 112 (93.3%) patients. One patient (<1%) required femoral access conversion to complete the procedure. Thirty (25.0%) patients required one or more additional access to facilitate crossing and/or to complete the planned treatment (5 femoral, 10 tibial, and 17 pedal). No serious adverse events were adjudicated to the procedure. Mean procedure time and time-to-ambulation was 74 minutes and 3 hours 30 minutes; respectively, with 93.3% same day discharge. At 30 days, 97.2% of patients had ultrasound-confirmed RA patency.
The findings of the study demonstrated that radial access for peripheral artery interventions was associated with favorable safety profiles. Notably, the incidence of access site complications and major adverse cardiovascular events was significantly lower compared to the traditional femoral access approach. The results also showed comparable procedural success rates and long-term clinical outcomes between the two approaches.
Additionally, radial access was found to have the potential to be a safe and effective alternative for performing peripheral artery interventions. The researchers believe that the wrist and forearm offer several advantages over the traditional femoral access site, including improved patient comfort, reduced bleeding complications, and faster ambulation. Further research and clinical trials are warranted to validate these findings and establish radial access as a mainstream approach in this field.
“This study contributes to the growing body of evidence supporting the use of radial access for peripheral artery interventions,” stated Mehdi Shishehbor, DO, MPH, PhD, president of University Hospitals Harrington Heart & Vascular Institute, Cleveland, OH, and lead author of the study. “As medical professionals continue to explore different approaches, advances in technology and techniques are expected to further enhance the safety and efficacy of these procedures. With its potential to improve patient outcomes and satisfaction, radial access may revolutionize the field of peripheral artery interventions.”
Reference:
Yulanka Castro-Dominguez, Jun Li, Ankur Lodha, Mitul Patel, Vamsi Krishna, Mehdi H. Shishehbor, Prospective, Multicenter Registry to Assess Safety and Efficacy of Radial Access for Peripheral Artery Interventions, DOI:https://doi.org/10.1016/j.jscai.2023.101107.
