title: Safety and Feasibility of Transradial Access for Visceral Interventions in Patients with Thrombocytopenia.
abstract: OBJECTIVE
  Transradial access (TRA) has shown lower morbidity and decreased bleeding complications compared to transfemoral access. This study evaluates the safety and feasibility of TRA in thrombocytopenic patients undergoing visceral interventions.
  
  
  METHODS
  Patients who underwent visceral interventions via the radial artery with platelet count less than or equal to 50,000/µL were included in the study. Outcome variables included technical success, access site, bleeding, transfusion, and neurological complications.
  
  
  RESULTS
  From July 1, 2012, to May 31, 2015, a total of 1353 peripheral interventions via TRA were performed, of which 85 procedures were performed in 64 patients (mean age 62.2 years) with a platelet count <50,000/µL (median 39,000/µL). Interventions included chemoembolization (n = 46), selective internal radiation therapy (n = 30), and visceral embolization (n = 9). Technical success was 97.6% with two cases of severe vessel spasm requiring ipsilateral femoral crossover. There was no major access site, bleeding, or neurological adverse events at 30 days. Minor access site hematomas occurred in five cases (5.9%) and were treated conservatively in all cases. Pre-procedural platelet transfusions were administered in 23 (27.1%) cases. There was no statistically significant difference in access site or bleeding complications between the transfused and nontransfused groups.
  
  
  CONCLUSIONS
  Transradial visceral interventions in patients with thrombocytopenia are both feasible and safe, possibly without the need for platelet transfusions.
authors.affiliation: Department of Interventional Radiology, Icahn School of Medicine at Mount Sinai, 1176 5th Avenue, New York, NY, 10029, USA.
authors.forename: J J
authors.initials: JJ
authors.lastname: Titano
authors.affiliation: Department of Interventional Radiology, Icahn School of Medicine at Mount Sinai, 1176 5th Avenue, New York, NY, 10029, USA.
authors.forename: D M
authors.initials: DM
authors.lastname: Biederman
authors.affiliation: Department of Interventional Radiology, Icahn School of Medicine at Mount Sinai, 1176 5th Avenue, New York, NY, 10029, USA.
authors.forename: B S
authors.initials: BS
authors.lastname: Marinelli
authors.affiliation: Department of Interventional Radiology, Icahn School of Medicine at Mount Sinai, 1176 5th Avenue, New York, NY, 10029, USA.
authors.forename: R S
authors.initials: RS
authors.lastname: Patel
authors.affiliation: Department of Interventional Radiology, Icahn School of Medicine at Mount Sinai, 1176 5th Avenue, New York, NY, 10029, USA.
authors.forename: E
authors.initials: E
authors.lastname: Kim
authors.affiliation: Department of Interventional Radiology, Icahn School of Medicine at Mount Sinai, 1176 5th Avenue, New York, NY, 10029, USA.
authors.forename: N E
authors.initials: NE
authors.lastname: Tabori
authors.affiliation: Department of Interventional Radiology, Icahn School of Medicine at Mount Sinai, 1176 5th Avenue, New York, NY, 10029, USA.
authors.forename: F S
authors.initials: FS
authors.lastname: Nowakowski
authors.affiliation: Department of Interventional Radiology, Icahn School of Medicine at Mount Sinai, 1176 5th Avenue, New York, NY, 10029, USA.
authors.forename: R A
authors.initials: RA
authors.lastname: Lookstein
authors.affiliation: Department of Interventional Radiology, Icahn School of Medicine at Mount Sinai, 1176 5th Avenue, New York, NY, 10029, USA. aaron.fischman@mountsinai.org.
authors.forename: A M
authors.initials: AM
authors.lastname: Fischman
mesh_terms: D000368:Aged; D001918:Brachytherapy / Q000379:methods*; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D004621:Embolization, Therapeutic / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017534:Radial Artery; D013921:Thrombocytopenia / Q000150:complications*; D016896:Treatment Outcome
keywords: Clinical practice; Organ, Intra-arterial; Specialty, Arterial intervention; Specialty, Artery; Subspecialty/technique