title: Complications of transbrachial arterial access for peripheral endovascular interventions.
abstract: OBJECTIVE
  To prospectively assess current limitations and complication rates of the transbrachial access technique for endovascular treatment of peripheral vascular pathologies.
  
  
  METHODS
  In total, 150 patients (112 men; mean age 66.3 ± 10.0 years) with arterial occlusive disease underwent endovascular therapy via a transbrachial access. Periprocedure data (sheath size, dose area product, fluoroscopy time, and procedure duration) were analyzed. Postprocedure complications of the puncture sites were categorized as minor (local hematoma, pseudoaneurysm, embolization, dissection, minor bleeding) and major (thrombotic occlusion, hematoma requiring surgery, major bleeding, nerve injury).
  
  
  RESULTS
  The minor and major complication rates were 14.0% (n = 21) and 2.7% (n = 4). The most frequent major complication was thrombotic occlusion of the brachial artery requiring surgical treatment (3/150, 2%). There was only one temporary palsy of the median nerve and no stroke. Local hematoma (15, 10%), pseudoaneurysm (3, 2%), or a combination of both (3, 2%) dominated the minor complications. The average dose area product and fluoroscopy time were 12,752.1 ± 9524.5 cGy*cm(2) and 24.3 ± 18.4 minutes, respectively, though procedure duration was acceptable (121.8 ± 48.9 minutes).
  
  
  CONCLUSIONS
  Complication rates of the transbrachial access for endovascular treatment of peripheral or visceral artery occlusive disease are tolerably low, making it a safe and an important alternative to the transfemoral access in selected cases, though the radiation exposure is rather high.
authors.affiliation: Hospitals of the Ludwig-Maximilians University of Munich, Germany karlamaria.treitl@med.uni-muenchen.de.
authors.forename: Karla Maria
authors.initials: KM
authors.lastname: Treitl
authors.affiliation: Hospitals of the Ludwig-Maximilians University of Munich, Germany.
authors.forename: Cosima
authors.initials: C
authors.lastname: König
authors.affiliation: Hospitals of the Ludwig-Maximilians University of Munich, Germany.
authors.forename: Maximilian F
authors.initials: MF
authors.lastname: Reiser
authors.affiliation: Hospitals of the Ludwig-Maximilians University of Munich, Germany.
authors.forename: Marcus
authors.initials: M
authors.lastname: Treitl
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001916:Brachial Artery; D002406:Catheterization, Peripheral / Q000009:adverse effects; D000077144:Clopidogrel; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D011446:Prospective Studies; D011677:Punctures / Q000009:adverse effects; D012307:Risk Factors; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine
keywords: endovascular treatment; occlusion; peripheral artery disease; radiation exposure; stenosis; transbrachial access; vascular access; visceral artery