Â鶹´«Ã½Ó³»­

Â鶹´«Ã½Ó³»­

Explore the latest content from across our publications
Join The Â鶹´«Ã½Ó³»­

Log In

Forgot Password?
Create New Account

Loading... please wait

Abstract Details

Distal Transradial access in the anatomical snuffbox: Single operator 51 case learning curve
Cerebrovascular Disease and Interventional Neurology
Cerebrovascular Disease and Interventional Neurology Posters (7:00 AM-5:00 PM)
179
To show that fluoroscopy time per vessel imaged for distal transradial artery access for neurovascular diagnostic angiography decreases as the operator grains experience in the method.
The transradial approach (TRA) has recently been adopted by neurointerventionalists. The benefits of TRA include reduced access site complications, increased patient comfort, earlier ambulation, and decreased time for postprocedural monitoring. The Distal transradial access method (dTRA) involves accessing the radial artery via the anatomic snuffbox. This approach allows the patient’s hand to remain in a more neutral position throughout the procedure although access is more challenging.  
A retrospective chart review was done of all patients on whom dTRA was performed between October 2018 until March 2020. Procedures were performed by 1 neuroendovascular fellow under the supervision of 1 neuroendovascular attending. Both received formal training in dTRA access. Only diagnostic angiographies were included. Cases with radial artery thrombosis or significant tortuosity requiring conversion were excluded. Procedures were performed under local anesthetic and conscious sedation. Patient demographics, procedural complications, procedural time, total fluoroscopy time, and total radiation were collected.
Included were 51 cases. The mean age was 51. Females accounted for 41.2% of the patients. Average number of vessels catheterized was 4.43, Average Fluoroscopy time per vessel was 4.67 minutes. An increase in case number had negative correlation with fluoroscopy time (Spearman’s rho correlation coefficient -.461 p=.001). The first 25 cases had a mean fluoroscopy time per vessel of 5.7 minutes and the 26 subsequent cases had a mean fluoroscopy time of 3.6 minutes (p=0.001). There were 4 conversions to conventional TRA (7.8%).  Vasospasm occured in 5 cases (9.8%) with conversion in 2 cases and the rest resolving with verapamil.
There is a learning curve with the operator continuing to improve even up to 51 cases. dTRA is shown to be safe and effective.  
Authors/Disclosures
Ivo Bach, MD
PRESENTER 		Dr. Bach has nothing to disclose.
Pratit D. Patel, MD (Capital Health) Dr. Patel has nothing to disclose.
No disclosure on file
Claire Ruane Ms. Ruane has nothing to disclose.
No disclosure on file
Priyank Khandelwal, MD Dr. Khandelwal has nothing to disclose.