Complications of femoral versus radial access in neuroendovascular procedures with propensity adjustment.

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  • Additional Information
    • Affiliation:
      Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA
      Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, Califronia, USA
    • Subject Terms:
    • Subject Terms:
    • Abstract:
      Background The transradial artery (TRA) approach for neuroendovascular procedures continues to gain popularity, but neurointerventionalists still lag behind interventional cardiologists in the adoption of a TRA-first approach. This study compares the complications and efficiency of the TRA approach to the standard transfemoral artery (TFA) approach at our institution during our initial phase of adopting a TRA-first approach. Methods A retrospective analysis was performed on all consecutive neuroangiographic procedures performed at a large cerebrovascular center from October 1, 2018 to June 30, 2019. The standard TFA approach was compared with TRA access, with the primary outcome of complications analyzed via a propensity-adjusted analysis. Results A total of 1050 consecutive procedures were performed on 877 patients during this 9-month period; 206 (20%) procedures were performed via TRA and 844 (80%) via TFA. The overall complication rate was significantly higher with the TFA procedures than with the TRA procedures (7% (60/844) vs 2% (4/206), respectively; p=0.003). A propensity-adjusted analysis showed that the TFA approach was a significant risk factor for a complication (OR 3.6, 95% CI 1.3 to 10.2, p=0.01). However, the propensity analysis showed that fluoroscopy times were on average 4 min less for TFA procedures than for TRA procedures (p=0.003). Conclusion The TRA approach for neuroendovascular procedures appears to be safer than the TFA approach. Although a steep learning curve is initially encountered when adopting the TRA approach, the transition to a TRA-first practice can be performed safely for neurointerventional procedures and may reduce complications.
    • Journal Subset:
      Biomedical; Europe; Peer Reviewed; UK & Ireland
    • ISSN:
      1759-8478
    • MEDLINE Info:
      NLM UID: 101517079
    • Publication Date:
      20200526
    • Publication Date:
      20200526
    • DOI:
      http://dx.doi.org/10.1136/neurintsurg-2019-015569
    • Accession Number:
      143369188
  • Citations
    • ABNT:
      CATAPANO, J. S. et al. Complications of femoral versus radial access in neuroendovascular procedures with propensity adjustment. Journal of NeuroInterventional Surgery, [s. l.], v. 12, n. 6, p. 611–615, 2020. DOI 10.1136/neurintsurg-2019-015569. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=143369188. Acesso em: 15 ago. 2020.
    • AMA:
      Catapano JS, Fredrickson VL, Tatsuhiro Fujii, et al. Complications of femoral versus radial access in neuroendovascular procedures with propensity adjustment. Journal of NeuroInterventional Surgery. 2020;12(6):611-615. doi:10.1136/neurintsurg-2019-015569
    • APA:
      Catapano, J. S., Fredrickson, V. L., Tatsuhiro Fujii, Cole, T. S., Koester, S. W., Baranoski, J. F., Cavalcanti, D. D., Wilkinson, D. A., Majmundar, N., Lang, M. J., Lawton, M. T., Ducruet, A. F., & Albuquerque, F. C. (2020). Complications of femoral versus radial access in neuroendovascular procedures with propensity adjustment. Journal of NeuroInterventional Surgery, 12(6), 611–615. https://doi.org/10.1136/neurintsurg-2019-015569
    • Chicago/Turabian: Author-Date:
      Catapano, Joshua S., Vance L. Fredrickson, Tatsuhiro Fujii, Tyler S. Cole, Stefan W. Koester, Jacob F. Baranoski, Daniel D. Cavalcanti, et al. 2020. “Complications of Femoral versus Radial Access in Neuroendovascular Procedures with Propensity Adjustment.” Journal of NeuroInterventional Surgery 12 (6): 611–15. doi:10.1136/neurintsurg-2019-015569.
    • Harvard:
      Catapano, J. S. et al. (2020) ‘Complications of femoral versus radial access in neuroendovascular procedures with propensity adjustment’, Journal of NeuroInterventional Surgery, 12(6), pp. 611–615. doi: 10.1136/neurintsurg-2019-015569.
    • Harvard: Australian:
      Catapano, JS, Fredrickson, VL, Tatsuhiro Fujii, Cole, TS, Koester, SW, Baranoski, JF, Cavalcanti, DD, Wilkinson, DA, Majmundar, N, Lang, MJ, Lawton, MT, Ducruet, AF & Albuquerque, FC 2020, ‘Complications of femoral versus radial access in neuroendovascular procedures with propensity adjustment’, Journal of NeuroInterventional Surgery, vol. 12, no. 6, pp. 611–615, viewed 15 August 2020, .
    • MLA:
      Catapano, Joshua S., et al. “Complications of Femoral versus Radial Access in Neuroendovascular Procedures with Propensity Adjustment.” Journal of NeuroInterventional Surgery, vol. 12, no. 6, June 2020, pp. 611–615. EBSCOhost, doi:10.1136/neurintsurg-2019-015569.
    • Chicago/Turabian: Humanities:
      Catapano, Joshua S., Vance L. Fredrickson, Tatsuhiro Fujii, Tyler S. Cole, Stefan W. Koester, Jacob F. Baranoski, Daniel D. Cavalcanti, et al. “Complications of Femoral versus Radial Access in Neuroendovascular Procedures with Propensity Adjustment.” Journal of NeuroInterventional Surgery 12, no. 6 (June 2020): 611–15. doi:10.1136/neurintsurg-2019-015569.
    • Vancouver/ICMJE:
      Catapano JS, Fredrickson VL, Tatsuhiro Fujii, Cole TS, Koester SW, Baranoski JF, et al. Complications of femoral versus radial access in neuroendovascular procedures with propensity adjustment. Journal of NeuroInterventional Surgery [Internet]. 2020 Jun [cited 2020 Aug 15];12(6):611–5. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=143369188