Proximal and distal radial artery approaches for endovascular percutaneous procedures: anatomical suitability by ultraso
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ULTRASONOGRAPHY
Proximal and distal radial artery approaches for endovascular percutaneous procedures: anatomical suitability by ultrasound evaluation Diego Meo1 · Daniele Falsaperla1 · Alessandro Modica1 · Maria Carla Calcagno1 · Federica Libra1 · Carla Desiderio1 · Stefano Palmucci1 · Pietro Valerio Foti1 · Andrea Giovanni Musumeci1 · Antonio Basile1 Received: 18 November 2019 / Accepted: 20 October 2020 © Italian Society of Medical Radiology 2020
Abstract Purpose To describe the variability of the radial artery (RA) diameters at 2 levels, proximal (pRA), within 2 cm to the styloid process, and distal (dRA) at the snuff box, both eligible accesses for percutaneous approach, and to correlate these diameters with population features. Methods A total of 700 patients (377 females, 323 males) have been enrolled from July 2018 to March 2019. The diameters of left and right RA were measured using ultrasound (US) examination. Diameters of pRA and dRA were compared between different sex and CRF (tabagism, hypertension, hyperlipidemia, BMI > 30, diabetes) using multivariate analysis and unpaired t test; the feasibility of radial access was evaluated considering a diameter ≥ of 2 mm as a cut-off or a vessel/sheath ratio >1. The time needed to perform each assessment of the four vessels was recorded. Results The average proximal diameter of pRA was 2.58 mm (sd = 0.58 mm). The caliber of the dRA resulted 19.5% lower than the proximal one, with an average diameter of 1.99 mm (sd = 0.47 mm). On unpaired t test, a significant difference was reported for two of the parameters taken into account: sex and a BMI > 30. Conclusion Our results show that 88% of patients have an estimated radial artery caliber suitable for pTRA at US examination. Males and patients with BMI > 30 show a higher mean pRA and dRA; thus, they could be the ideal candidates for radial access. Keywords Snuff box · Radial access · Us evaluation · Interventional radiology
Introduction Transradial artery approach (TRA) is associated with a considerable decreased risk of vascular and hemorrhagic complications and easier achievement of postprocedural
hemostasis compared to transfemoral artery approach (TFA) in interventional radiology procedures [1, 2]. Other advantages of TRA are shorter time of patient recovery, reduced costs and greater patient gratification [3]. Furthermore, TRA may be technically very advantageous in obese patients [2].
* Diego Meo [email protected]
Stefano Palmucci [email protected]
Daniele Falsaperla [email protected]
Pietro Valerio Foti [email protected]
Alessandro Modica [email protected]
Andrea Giovanni Musumeci [email protected]
Maria Carla Calcagno [email protected]
Antonio Basile [email protected]
Federica Libra [email protected]
1
Carla Desiderio [email protected]
Department of Medical Surgical Sciences and Advanced Technologies “G. F. Ingrassia” – Radiology I Unit, University Hospital “Policlinico-Vittorio Emanuele”, Via Santa So
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