title: Safety and feasibility of iliac endovascular interventions with a radial approach. Results from a multicenter study coordinated by the Italian Radial Force.
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.
authors.affiliation: Interventional Cardiology, A.O. Fatebenefratelli Milano, Italy. Electronic address: bcortese@gmail.com.
authors.forename: Bernardo
authors.initials: B
authors.lastname: Cortese
authors.affiliation: Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Trani
authors.affiliation: U.O. Cardiologia, Ospedale Campo di Marte, Lucca, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Lorenzoni
authors.affiliation: U.O. di Cardio-Angiologia Diagnostica e Interventistica, Villa Maria Cecilia Hospital, Cotignola, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Sbarzaglia
authors.affiliation: Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, and Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: Azeem
authors.initials: A
authors.lastname: Latib
authors.affiliation: Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Tommasino
authors.affiliation: U.O. Cardiologia, Ospedale Campo di Marte, Lucca, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Bovenzi
authors.affiliation: U.O. di Cardio-Angiologia Diagnostica e Interventistica, Villa Maria Cecilia Hospital, Cotignola, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Cremonesi
authors.affiliation: Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Burzotta
authors.affiliation: Cardiac Dpt., Cliniche Gavazzeni, Bergamo, Italy.
authors.forename: Antonino
authors.initials: A
authors.lastname: Pitì
authors.affiliation: Interventional Cardiology, AUSL Forlì, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Tarantino
authors.affiliation: Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, and Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Colombo
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D057510:Endovascular Procedures / Q000009:adverse effects* / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000601:surgery*; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D017534:Radial Artery / Q000601:surgery*; D016896:Treatment Outcome
keywords: Iliac intervention; Percutaneous transluminal angioplasty; Transradial approach