Safety and feasibility of iliac endovascular interventions with a radial approach. Results from a multicenter study coordinated by the Italian Radial Force

Bernardo Cortese, Carlo Trani, Roberto Lorenzoni, Paolo Sbarzaglia, Azeem Latib, Antonella Tommasino, Francesco Bovenzi, Alberto Cremonesi, Francesco Burzotta, Antonino Pitì, Fabio Tarantino, Antonio Colombo

Research output: Contribution to journalArticlepeer-review

27 Scopus citations

Abstract

Background Percutaneous angioplasty of lower limb disease is commonly performed with a transfemoral access. In the coronary field, a transradial approach has shown to reduce access-site bleeding and adverse clinical events. This route has not yet been well studied for the majority of peripheral interventions, like those involving the iliac arteries. In this study we sought to evaluate the feasibility and safety of this approach for iliac interventions. Methods Multicenter study was performed at high-volume centers with experience in transradial percutaneous interventions. Primary endpoint of the study was procedural success; secondary endpoints included in-hospital bleeding, 1-month freedom from adverse events and the rate of radial occlusion. Feasibility of this technique was evaluated by recording procedural and fluoroscopy time and contrast load. Results A total of 149 patients from 5 centers were enrolled. The population had a medium risk profile, with 48% of patients having TASC 2 or 3 lesions. Procedural success was achieved in 98.7% of the population, and we did not register in-hospital complications, including both vascular access site and procedural-related complications. An ancillary transfemoral approach was used in 13% of patients. One-month freedom from symptoms was achieved in 97.3% of patients, and the rate of radial occlusion was 2.7%. Major determinants of an unsuccessful procedure were the use of normal 6 or 7-Fr introducer with guiding catheter, TASC D lesion attempt, lesion length > 30 mm and total occlusion. Conclusions A transradial approach for iliac disease may be a feasible and safe alternative to the transfemoral route in experienced hands, in the light of significant technical improvements and dedicated devices.

Original languageEnglish (US)
Pages (from-to)280-284
Number of pages5
JournalInternational Journal of Cardiology
Volume175
Issue number2
DOIs
StatePublished - Aug 1 2014
Externally publishedYes

Keywords

  • Iliac intervention
  • Percutaneous transluminal angioplasty
  • Transradial approach

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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