title: Hemodynamic Assessment of Severe Aortic Stenosis via Transradial Approach is Safe.
abstract: BACKGROUND
  Patients with a discrepancy between clinical presentation and echocardiographic severity of aortic stenosis require invasive hemodynamic assessment. The comparative safety and feasibility of transradial cardiac catheterization in comparison with the traditional transfemoral approach in this usually complex subset of patients is not known. We sought to evaluate the safety, feasibility, and time to cross severely stenosed aortic valves via radial approach.
  
  
  METHODS
  All patients who were successfully assessed for aortic stenosis with a dual-lumen catheter and found to have severe aortic stenosis (calculated aortic valve area <1.0 cm2) in the last 2 years at our institution were retrospectively evaluated. Demographic, clinical, and procedural data were compared between the TF group (femoral arterial and venous access) and TR group (radial artery and basilic or cephalic vein access).
  
  
  RESULTS
  A total of 176 patients underwent left and right heart catheterization using femoral access, while 58 patients had their procedures performed via radial artery and arm vein access. Fluoroscopy time was comparable between TR and TF groups (14.97 ± 4.6 minutes vs 12.90 ± 3.9 minutes, respectively; P=.23), as was the time to cross the aortic valve (132 ± 209 seconds vs 128 ± 226 seconds, respectively; P=.39). Incidence of cerebrovascular events was not different between the two groups (2.3% vs 1.75%, respectively; P=.14). Access-site complications were significantly higher in the TF group vs the TR group (5.11% vs 0%, respectively; P<.01).
  
  
  CONCLUSIONS
  Transradial retrograde crossing of severely stenosed aortic valve is feasible using ordinary equipment, with reduced access-site related complications.
authors.affiliation: Deborah Heart & Lung Center, 200 Trenton Road, Browns Mills, NJ 08015 USA. sanghvik@deborah.org.
authors.forename: Kintur
authors.initials: K
authors.lastname: Sanghvi
authors.forename: Samir
authors.initials: S
authors.lastname: Pancholy
authors.forename: Tejas
authors.initials: T
authors.lastname: Patel
mesh_terms: D000368:Aged; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000503:physiopathology*; D006328:Cardiac Catheterization / Q000379:methods*; D017023:Coronary Angiography / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005471:Fluoroscopy / Q000379:methods*; D005500:Follow-Up Studies; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D017534:Radial Artery; D012189:Retrospective Studies; D012720:Severity of Illness Index