Combined Transradial and Transpedal Approach for Femoral Artery Interventions

Zoltán Ruzsa, Robert Bellavics, B. Nemes, Artúr Hüttl, András Nyerges, P. Sótonyi, Olivier Francois Bertrand, Kálmán Hüttl, B. Merkely

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7 Citations (Scopus)

Abstract

Objectives: The purpose of this prospective study was to evaluate the acute success and complication rates of combined transradial and transpedal access for femoral artery intervention. Background: Improved equipment and techniques have resulted in transition from transfemoral to transradial access for intervention of superficial femoral artery. Methods: Between 2014 and 2016, clinical and angiographic data from 145 consecutive patients with symptomatic superficial femoral stenosis, treated via primary radial access using the 6-F SheathLess Eaucath PV guiding catheter were evaluated in a pilot study. Secondary access was achieved through the pedal or popliteal artery. The primary endpoints were major adverse events, target lesion revascularization, and rates of major and minor access-site complications. Secondary endpoints included angiographic outcome, procedural factors, crossover rate to femoral access site, and duration of hospitalization. Results: Technical success was achieved in 138 patients (95.2%). Combined radial and pedal access was obtained in 22 patients (15.1%). The crossover rate to a femoral access site was 2%. Stent implantation was necessary in 23.4% of patients. Chronic total occlusion recanalization was performed in 63 patients, with a 90.4% technical success rate. The mean contrast consumption, radiation dose, and procedure time were 112.9 ml (101.8 to 123.9 ml), 21.84 Gy/cm2 (9.95 to 33.72 Gy/cm2), and 34.9 min (31.02 to 38.77 min), respectively. The cumulative rate of access-site complications was 4.8% (0% major, 4.8% minor). The cumulative incidence rates of major adverse events at 3 and 12 months follow-up was 8.3% and 19.2%. The cumulative incidence rates of death at 3- and 12-month follow-up were 2.8% and 5.6%. Conclusions: Femoral artery intervention can be safely and effectively performed using radial and pedal access with acceptable morbidity and a high technical success rate.

Original languageEnglish
Pages (from-to)1062-1071
Number of pages10
JournalJACC: Cardiovascular Interventions
Volume11
Issue number11
DOIs
Publication statusPublished - Jun 11 2018

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Keywords

  • femoral artery angioplasty
  • femoral artery stenting
  • transpedal approach
  • transradial approach

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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