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- W2313377833 abstract "Transradial access (TRA) has been shown to decrease complications vs. transfemoral access (TFA) in coronary intervention. TRA for peripheral and visceral interventions is less common but has been reported to offer comparable therapeutic efficacy as TFA in chemoembolization with lower overall access-site complications. Additionally, the lack of need for an arterial closure device in TRA affords patients faster time to ambulation and discharge. We reviewed adverse events in patients undergoing TRA in a large academic medical center. Retrospective review was conducted on 1004 procedures performed in 668 patients undergoing TRA from 4/2012 to 10/2014. Procedures included: chemoembolization (n=371), Y90 mapping (n=249) and infusion (n=168), renal/visceral intervention (n=104), uterine artery embolization (n=65), peripheral intervention (n=37), endoleak (n=8), and other (n=2). A pulse oximeter was used on the ipsilateral thumb to confirm dual circulation and patency of the palmar arch (Barbeau Test). Ultrasound of the radial artery (RA) verified adequate vessel size. TRA contraindications included: RA<2mm and Barbeau D waveform. After RA puncture, a hydrophilic Glidesheath (Terumo Interventional Systems) was placed and 3000U heparin, 2.5mg verapamil, and 200mcg nitroglycerin was given to minimize vascular complication. Following the procedure, a TR band (Terumo) was used for hemostasis. Procedural details and 30-day adverse events (AEs) were evaluated (CTCAE v4.0). Technical success via TRA was obtained in 998/1004 cases (99.4%), with 6 cases requiring TFA crossover (0.6%). Overall major AEs were 0.3%: 1 large hematoma requiring TFA crossover, 1 pseudoaneurysm requiring intervention, and 1 verapamil induced seizure. Minor adverse event rate was 3.2%: RA occlusion (n=11, 3 crossover), hematoma/bleeding (n=9), RA thrombosis (n=5, 1 crossover), arteritis (n=3), pain/numbness (n=2), and severe vasospasm (n=2, 1 crossover). All minor AEs were either asymptomatic or managed conservatively. There were no additional AEs at 30 days. TRA appears safe and well tolerated in a typical IR patient population with extremely low complication rates and warrants further large-scale investigation." @default.
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- W2313377833 date "2015-02-01" @default.
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- W2313377833 title "FEATURED ABSTRACT, Transradial approach for peripheral and visceral interventions: a single-center review of safety and feasibility in the first 1000 cases" @default.
- W2313377833 doi "https://doi.org/10.1016/j.jvir.2014.12.273" @default.
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