Transradial approach for diagnostic cerebral angiograms in the elderly: a comparative observational study.

Abstract:

BACKGROUND:The transradial approach (TRA) reduces mortality, morbidity, access site complications, hospital cost, and length of stay while maximizing patient satisfaction. We aimed to assess the technical success and safety of TRA for elderly patients (aged ≥75 years). METHODS:A retrospective chart review and comparative analysis was performed for elderly patients undergoing a diagnostic cerebral angiogram performed via TRA versus transfemoral approach (TFA). Also, a second comparative analysis was performed among the TRA cohort between elderly patients and their younger counterparts. RESULTS:Comparative analysis in the elderly (TRA vs TFA) showed no significant differences for contrast dose per vessel (43.7 vs 34.6 mL, P=0.106), fluoroscopy time per vessel (5.7 vs 5.2 min, P=0.849), procedure duration (59.8 vs 65.2 min, P=0.057), conversion rate (5.8% vs 2.9%, P=0.650), and access site complications (2.3% vs 2.9%, P=1.00). Radiation exposure per vessel (18.9 vs 51.9 Gy cm2, P=0.001) was significantly lower in the elderly TRA group.The second comparison (TRA in elderly vs TRA in the young) showed no significant differences for contrast dose per vessel (43.7 vs 37.8 mL, P=0.185), radiation exposure per vessel (18.9 vs 16.5 Gy cm2, P=0.507), procedure duration (59.8 vs 58.3 min, P=0.788), access site complication (2.3% vs 1.7%, P=0.55), and conversation rate (5.8% vs 1.8%, P=0.092). A trend for prolonged fluoroscopy time per vessel (5.7 vs 4.7 min, P=0.050) was observed in the elderly TRA group. CONCLUSIONS:TRA is a technically feasible and safe option for diagnostic neurointerventional procedures in the elderly. Our small elderly cohort was not powered enough to show a significant difference in terms of access site complications between TRA and TFA.

journal_name

J Neurointerv Surg

authors

Sweid A,Das S,Weinberg JH,E L Naamani K,Kim J,Curtis D,Joffe D,Hiranaka CG,Vijaywargiya D,Sioka C,Oneissi M,El Hajjar AH,Gooch MR,Herial N,Tjoumakaris SI,Rosenwasser RH,Jabbour P

doi

10.1136/neurintsurg-2020-016140

subject

Has Abstract

pub_date

2020-12-01 00:00:00

pages

1235-1241

issue

12

eissn

1759-8478

issn

1759-8486

pii

neurintsurg-2020-016140

journal_volume

12

pub_type

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