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• W3048093105 abstract "We read with interest the recent article on safety and efficacy of radial access for angio-embolisation in splenic trauma patients by Adnan et al.1Adnan S.M. Romagnoli A.N. Martinson J.R. Madurska M.J. Dubose J.J. Scalea T.M. et al.A comparison of transradial and transfemoral access for splenic angio-embolisation in trauma: a single centre experience.Eur J Vasc Endovasc Surg. 2020; 59: 472-479Abstract Full Text Full Text PDF PubMed Scopus (10) Google Scholar The authors are to be congratulated on demonstrating a feasible and low risk alternative access for endovascular treatment in this critical patient population, who often have complicated groins making femoral access more challenging or undesirable. That none of the patients suffered traumatic neurological injury is remarkable, as this patient population often suffers from polytrauma including concomitant closed head injury and has a trauma induced coagulopathy. Even if they have high to normal GCS, many are sedated or intubated, and haemorrhagic findings may be subtle or even below the threshold of CT detection.2Amrhein T.J. Mostertz W. Matheus M.G. Maass-Bolles G. Sharma K. Collins H.R. et al.Reformatted images improve the detection rate of acute traumatic subdural hematomas on brain CT compared with axial images alone.Emerg Radiol. 2017; 24: 39-45Crossref PubMed Scopus (6) Google Scholar As not all patients received 5000 units of intra-procedural heparin, we would ask the authors to clarify whether this decision was based on departmental protocol or the preference of individual surgeons. We would caution from personal experience that administration of heparin to preserve radial access (typically asymptomatic even when occluded) should be carefully weighed against the potential for exacerbation, or incitement, of intra-cranial haemorrhage.3Golob J.F. Sando M.J. Kan J.C. Yowler C.J. Malangoni M.A. Claridge J.A. Therapeutic anticoagulation in the trauma patent: is it safe?.Surgery. 2008; 144: 591-597Abstract Full Text Full Text PDF PubMed Scopus (12) Google Scholar This is important for the reader to consider against the small risk of major, but usually treatable, complication of femoral access. A Comparison of Transradial and Transfemoral Access for Splenic Angio-Embolisation in Trauma: A Single Centre ExperienceEuropean Journal of Vascular and Endovascular SurgeryVol. 59Issue 3PreviewThe study compared transradial access (TRA) and transfemoral access (TFA) for splenic angio-embolisation (SAE), with a focus on technical success, intra-operative adjuncts, and complications. Full-Text PDF Open Archive" @default.
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• W3048093105 date "2021-02-01" @default.
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• W3048093105 title "Re ‘A Comparison of Transradial and Transfemoral Access for Splenic Angio-Embolisation in Trauma: A Single Centre Experience’" @default.
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• W3048093105 doi "https://doi.org/10.1016/j.ejvs.2020.06.043" @default.
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