PAD intervention via radial access successful, safe in small multicenter cohort
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Key takeaways:
- Endovascular treatment via radial access for the treatment of peripheral artery disease was successful in 93.3% of patients.
- No 30-day access site-related complications were reported.
Endovascular treatment of peripheral artery disease via radial access was feasible and safe in a small multicenter cohort, with only one patient requiring conversion to femoral access during, researchers reported.
The prospective analysis of the R2P Registry was published in the Journal of the Society for Cardiovascular Angiography and Interventions.
“This study contributes to the growing body of evidence supporting the use of radial access for peripheral artery interventions,” Mehdi Shishehbor, DO, MPH, PhD, professor of medicine at Case Western Reserve University School of Medicine and president of University Hospitals Harrington Heart & Vascular Institute, said in a press release. “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.”
In this prospective registry analysis, 120 patients at eight U.S. centers were enrolled (mean age, 69 years; 32% women). Patients with PAD scheduled for complex endovascular lower extremity interventions via radial access between June 2020 and June 2021 were included.
Overall, 55.3% of treated lesions were in femoropopliteal vessels while 19.5% were in tibial vessels, 12.9% were in iliac vessels and 11.9% were in isolated popliteal vessels.
The primary efficacy endpoint was procedural success — defined as success without conversion to femoral access or periprocedural radial access complications — and was achieved in 93.3% of patients. One patient required conversion to femoral access.
Overall, 25% of patients required one or more additional access to facilitate crossing and/or complete the procedure, according to the study.
No occurrences of the primary safety endpoint— 30-day access site-related complications — were reported.
In addition, the average procedure time was 74 minutes; average time to ambulation was 3 hours and 30 minutes; 93.3% of participants had same-day discharge; and 97.2% of patients had ultrasound-confirmed radial artery patency at 30 days.
“Without a femoral-only access group, we are not able to make direct comparisons and conclusions on benefits or disadvantages of each access. However, the main goal of this study was to prove the feasibility of [radial access] for complex multilevel peripheral interventions with low rate of complications and short procedural times,” Yulanka Castro-Dominguez, MD, clinical assistant professor at Case Western Reserve University and interventional cardiologist and vascular medicine specialist at University Hospitals Harrington Heart & Vascular Institute, and colleagues wrote. “Long-term patency data was lacking on this report, and given the specific devices used would be of relevance. Future studies should compare technical and clinical success, procedural time and costs associated with transradial vs. transfemoral peripheral intervention.”
Reference:
- Society for Cardiovascular Angiography and Interventions. https://scai.org/new-study-assesses-safety-and-efficacy-radial-access-peripheral-artery-interventions. Published Oct. 16, 2023. Accessed Oct. 16, 2023.
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Castro-Dominguez Y, et al. J Soc Cardiovasc Angiogr Interv. 2023;doi:10.1016/j.jscai.2023.101107.
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