Safety of ultrasound-guided distal radial artery access for abdominopelvic transarterial interventions: a prospective study

Özet

PURPOSEWe aimed to evaluate ultrasound-guided distal radial artery (DRA) access to perform abdominopelvic endovascular procedures.METHODSA prospective, observational study was carried out in a single center between December 2017 andFebruary 2019. Forty-two abdominopelvic endovascular procedures were performed by the sameoperator in 37 patients with DRA access using a 5 F sheath. Most patients were male (67.6%) witha mean age of 62.0±11.4 years (age range, 27.6–82.8 years). Patient characteristics, including Barbeau’s test classification, radial and ulnar sizes and technical success, were evaluated. Patients witha DRA smaller than 1.7 mm could not be safely punctured and were not included.RESULTSProcedures included chemoembolization of hepatocellular carcinoma in 35 cases (83.3%), embolization of hepatic metastasis in neuroendocrine tumors in 4 cases (9.5%) and other embolizationprocedures in 3 cases (7.1%). The mean diameters of the DRA, proximal radial artery and proximalulnar artery were 2.31, 2.63, and 2.09 mm, respectively. Out of 42 DRA puncture attempts, 97.6%(41/42) were successfully performed. There were no postoperative complications related to theaccess site, such as pain, palsy, paresthesia, occlusion, finger ischemia, bleeding, hematoma, andpseudoaneurysm. Transient forearm discomfort was reported in 7.1% of patients (3/42); one occurrence was associated with kinking rectification, and two occurrences were attributed to smallarteries and/or vasospasm.CONCLUSIONUltrasound-guided DRA access seems to be feasible and safe to perform in abdominopelvic endovascular procedures in patients with a DRA considered amenable to be safely punctured, withhigh technical success rates.