Prone transradial catheterization for combined single-session endovascular and percutaneous interventions: approach, technical success, safety, and outcomes in 15 patients

Özet

PURPOSEWe aimed to report approach, safety, technical success, and clinical outcomes of prone transradialaccess (PTRA) and demonstrate feasibility for procedures requiring simultaneous arterialintervention and prone percutaneous access.METHODSFifteen patients underwent PTRA, seven females (47%) and eight males (53%), mean age of 55years (range, 19–78 years). All patients underwent PTRA for combined transarterial and posterior-approach percutaneous interventions. Variables included sheath size (French, F), type of anesthesia,arterial intervention technical success, posterior-approach percutaneous interventiontechnical success, estimated blood loss (mL), fluoroscopy and procedure time, complications,and follow-up.RESULTSMean sheath size was 4 F (range, 4–6 F; SD = 0.5). Arterial interventions included transarterialembolization of renal (n=6), hepatic (n=2), and pelvic vessels (n=2), diagnostic arteriography(n=4), and embolization of an arteriovenous malformation (n=1). Posterior-approach interventiontechnical success was 100% (15/15). PTRA technical success was 100% (15/15). Posterior-approachpercutaneous interventions included retroperitoneal (n=5) and pelvic (n=1) mass biopsies,nephrostomy tube placement (n=2), cryoablation of pelvic (n=2) and renal (n=1) masses,sclerotherapy of arteriovenous malformations (n=2), foreign body removal from the renal collectingsystem (n=2), ablation of a renal tumor (n=1), intracavitary injection of pulmonary mycetoma(n=1), and ablation and cementoplasty of a vertebral body tumor (n=1). The biopsies werediagnostic (6/6). There were no minor or major access-site complications.CONCLUSIONPTRA is a safe and feasible method for performing combined arterial and posterior approachpercutaneous interventions without the need for repositioning.