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Combined radial-pedal access successful in femoral artery interventions
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Interventional procedures in femoral arteries were successfully performed via primary radial artery access and secondary pedal or popliteal artery access, researchers reported.
The researchers analyzed 145 consecutive patients (mean age, 68 years; 63% men) who underwent treatment for symptomatic superficial femoral stenosis via primary radial access via guiding catheter (SheathLess Eaucath PV, Asahi Intecc) and secondary pedal or popliteal access at a single center between 2014 and 2016.
Primary endpoints were major adverse events, and major or minor access-site complications.
The technical success rate was 95.2%, 15.1% of patients had combined radial and pedal access and 2% of patients crossed over to femoral access, Zoltán Ruzsa, MD, PhD, from Semmelweis University of Budapest Heart and Vascular Center, and colleagues wrote.
Stent implantation was needed in 23.4% of patients and recanalization for chronic total occlusion was performed in 63 patients with a technical success rate of 90.4%, according to the researchers.
There were no major access-site complications, and 4.8% of patients had minor access-site complications, they wrote.
At 3 months, 8.3% of patients had major adverse events, and at 12 months, 19.2% of patients had them. Mortality rates were 2.8% at 3 months and 5.6% at 12 months.
Mean contrast consumption was 112.9 mL (95% CI, 101.8-123.9), mean radiation dose was 21.84 Gy/cm2 (95% CI, 9.95-33.72) and mean procedure time was 34.9 minutes (95% CI, 31.02-38.77).
In a related editorial, Ehrin J. Armstrong, MD, MSc, and Javier Valle, MD, MSCS, both from Veterans Affairs Eastern Colorado Health Care System, Denver, and the University of Colorado School of Medicine, wrote: “Single-center analyses demonstrate feasibility but do not offer strong enough evidence for safety or overall procedural success. A multicenter trial comparing combined radial and pedal approaches to femoral access is needed to truly begin to assess efficacy and safety. Response from industry is on the horizon, but greater diversity in device and therapeutic options is needed.” – by Erik Swain
Disclosures: The authors and Valle report no relevant financial disclosures. Armstrong reports he consults for Abbott Vascular, Boston Scientific, Cardiovascular Systems Inc., Medtronic and Philips.
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