Safety and efficacy of transradial aortoiliac interventions.
BACKGROUND
This study compares transradial approach (TRA) aortoiliac angioplasty/stenting to the transfemoral approach (TFA).


METHODS
We reviewed our peripheral database for aortoiliac interventions performed between 2007 and 2009. Demographics, clinical characteristics, procedural, and lesion details were collected. The efficacy endpoints included procedural success, ankle-brachial index (ABI) improvement, and time to discharge. The safety endpoints were as follows: occurrence of intra-/periprocedural complications, 30-day MACE, and access-site complications (minor/major). The subjects were divided into two groups, TRA and TFA, and compared using appropriate statistics.


RESULTS
Twenty-seven patients had 33 lesions treated via TRA, and 41 patients had 47 lesions treated via TFA access. Baseline demographic differences between the TRA and TFA groups were similar, including mean Rutherford category (2.9 vs. 2.6, P = 0.31) and preintervention ABI (0.64 vs. 0.67, P = 0.80). There was a significantly higher percentage of total occlusions in the TRA group (27.3 vs. 8.5%, P = 0.03). Dye use (238 vs. 213 mL, P = 0.35) and fluoroscopy time (30 vs. 27 min, P = 0.60) were similar. Procedural success rate was similar (87.9 vs. 97.8%, P = 0.15), as well as the improvement in mean ABI (TRA: 0.64-0.77 and TFA: 0.67-0.85, P = 0.77). The time to discharge was significantly shorter for the TRA group (14.4 vs. 20.9 hr, P = 0.003). There were no 30-day MACE or major access-site complications, but minor access-site complications were lower in the TRA group (0.0 vs. 7.3%, P = 0.28), although nonsignificant.


CONCLUSIONS
The TRA to aortoiliac interventions is as safe and effective as the TFA with the advantage of a lower rate of access-site complications and shorter hospitalization time.
Staniloae
Cezar S
CS
Division of Cardiovascular Diseases, Saint Vincent Catholic Medical Center, New York, New York, USA. cstaniloae@aol.com
Korabathina
Ravikiran
R
Yu
Jennie
J
Kurian
Damian
D
Coppola
John
J
D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D055109:Ankle Brachial Index; D001018:Aortic Diseases / Q000175:diagnosis / Q000628:therapy*; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000628:therapy*; D003251:Constriction, Pathologic; D019992:Databases as Topic; D005260:Female; D005263:Femoral Artery; D005471:Fluoroscopy; D006801:Humans; D007083:Iliac Artery; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D017534:Radial Artery; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome