Radical Radial: Pearls and Pitfalls in Transradial Yttrium-90 Liver-Directed Therapy
The frequency of transradial access in interventional radiology has been steadily increasing, including for yttrium-90 (Y-90) selective internal radiation therapy to treat hepatic malignancies. The aim of this article is to detail an optimized approach to transradial Y-90 (TRY-90), showing it to be a safe and feasible first-line approach to hepatic selective internal radiation therapy. Salient preprocedural considerations to enable appropriate patient selection for TRY-90 are discussed and a detailed equipment list is provided. The article will describe our approach to TRY-90 in addition to a discussion around technical pearls and pitfalls.
Operator Learning Curve for Transradial Liver Cancer Embolization: Implications for the Initiation of a Transradial Access Program
We aimed to analyze transradial access (TRA) learning curve on patients undergoing hepatic chemoembolization, investigating the relationship between procedural volumes and various benchmarks of procedural success.
Transradial Access for Neurointerventions: Management of Access Challenges and Complications
Numerous large randomized trials have shown a significant morbidity and mortality benefit with the transradial approach (TRA) over the transfemoral approach (TFA) for endovascular procedures. However, this technique is routinely avoided or aborted due to unfamiliarity with the technique and the associated anatomical difficulties that may be faced in this approach. The objective of this review is to identify both the common and uncommon challenges that may be encountered during a transradial approach for cerebrovascular catheterization and to provide tips and tricks to overcome the transradial learning curve.
Distal Transradial Access in the Anatomic Snuffbox for Diagnostic Cerebral Angiography
The aim of this study was to describe the feasibility, technique, and safety of distal transradial access in the anatomic snuffbox for diagnostic cerebral angiography. A retrospective review of diagnostic cerebral angiograms obtained during a 6-month period with distal transradial access was performed. Thirty-four successful procedures were performed via distal transradial access. There were 4 failed attempts. This single-center experience using distal transradial access suggests that this technique is safe and effective.
Transitioning to Transradial Access for Cerebral Aneurysm Embolization
Despite several retrospective studies showing the safety and efficacy of transradial access for cerebral angiography, neurointerventionalists are apprehensive about implementing TRA for neurointerventions. This reluctance is mainly due to anatomic factors, technical factors, and a long learning curve (relative to transfemoral access). We present here our experience of TRA transition for cerebral aneurysm embolization. Our aim was to demonstrate the feasibility and safety of radial access for consecutive embolizations of ruptured and unruptured cerebral aneurysms.
Feasibility of repeat transradial access for neuroendovascular procedures
Transradial artery access (TRA) for cerebrovascular angiography is increasing due to decreased access site complications and overwhelming patient preference. While interventional cardiologists have reported up to 10 successive TRA procedures via the same radial access site, this is the first study examining successive use of the same artery for repeat procedures in neurointerventional procedures.
Single-Center Retrospective Comparative Analysis of Transradial, Transbrachial, and Transfemoral Approach for Mesenteric Arterial Procedures
To assess feasibility and safety of transradial access (TRA) compared with transfemoral access (TFA) and transbrachial access (TBA) for mesenteric arterial endovascular procedures.
Expedited TR Band Removal for Transradial Approach for Noncoronary Visceral Procedures: Initial Experience.
For transradial interventions, most published studies report an initial Terumo Radial (TR) band placement time of 60 minutes, with gradual deflation over 30 to 90 minutes. We aimed to determine, retrospectively, whether TR band removal time could be expedited to 45 to 60 minutes, without adverse effects via an expedited single-step deflation protocol.
Initial experience with transradial access for cerebrovascular procedures: is it feasible and safe?
Despite the proven benefit of transradial access over transfemoral access in cardiac procedures, the transition for cerebrovascular procedures has only been slowly enforced. Here we present our experience with transradial access in cerebral diagnostic angiographies and neurointerventional procedures.
Prospective Study on Total Fluoroscopic Time in Patients Undergoing Uterine Artery Embolization: Comparing Transradial and Transfemoral Approaches
This study compares total fluoroscopy time (FT) to perform uterine artery embolization (UAE) with transradial approach (TRA) versus transfemoral approach (TFA). Our hypothesis was that there would be no significant procedural time penalty incurred, despite the learning curve associated with adopting a new approach.
A Novel Approach to Reduce Radial Artery Occlusion After Transradial Catheterization: Postprocedural/Prehemostasis Intra-arterial Nitroglycerin
This research evaluates whether administration of nitroglycerin through the sheath at the end of a transradial procedure might preserve the patency of the radial artery.
Patient Radiation Exposure in Transradial versus Transfemoral Yttrium-90 Radioembolization: A Retrospective Propensity Score-Matched Analysis
This study compares differences in patient radiation exposure (PRE) during transarterial yttrium-90 (90Y) radioembolization (TARE) between transradial access (TRA) and transfemoral access (TFA).
Transradial Versus Transfemoral Arterial Access in Liver Cancer Embolization: Randomized Trial to Assess Patient Satisfaction
This study set out to determine whether transradial access (TRA) or transfemoral access (TFA) provides better patient satisfaction during intra-arterial therapy (IAT) for liver cancer.
Transradial versus Transfemoral Access for Hepatic Chemoembolization: Intrapatient Prospective Single-Center Study
This article compares the transfemoral approach (TFA) and transradial approach (TRA) in patients undergoing hepatic chemoembolization in terms of safety, feasibility, and procedural variables, including ﬂuoroscopy time, radiation dose (reference air kerma [RAK]), and patient preference.
Cone-beam CT Acquisition During Transradial TACE Made Easy: Use of the Swivel Arm Board
Having recently introduced a swivel arm board to allow seamless repositioning of the access arm during and after CBCT acquisition, this study details the technique and feasibility of this useful adjunct to transradial TACE.
Transradial Approach for Mechanical Thrombectomy in Anterior Circulation Large-vessel Occlusion
This study describes the authors’ recent institutional experience with the transradial approach to anterior circulation large-vessel occlusions (LVOs) in acute ischemic stroke patients and to report its technical feasibility.
Transradial Approach for Hepatic Radioembolization: Initial Results and Technique
Selective internal radiation therapy (SIRT) performed via the TRA can enhance patient comfort, compared with the traditional transfemoral approach (TFA), by allowing immediate ambulation and precluding potential complications associated with the TFA, such as closure device injury or retroperitoneal hematoma. This report shares initial experience with and technique for using the TRA for SIRT.
Embolization of a Chest Wall Arterial Venous Malformation Using a Transradial Approach
This article reports on the usefulness of TRA in embolization of a chest wall AVM with inferior coursing, intercostal “feeder” arteries forming obtuse angles with the descending thoracic aorta, more readily cannulated by a superior TRA.
Technical Feasibility of Prostatic Artery Embolization From a Transradial Approach
This study evaluates the technical feasibility of performing prostatic artery embolization (PAE) with a transradial approach (TRA). Nineteen consecutive PAEs performed using a TRA were reviewed to determine the technical success of the procedure, which was defined as bilateral embolization.
Radial Versus Femoral Access in Patients with Acute Coronary Syndromes Undergoing Invasive Management: A Randomised Multicentre Trial
Article that explores whether radial compared with femoral access improves outcomes in unselected patients with acute coronary syndromes undergoing invasive management.
Percutaneous Radial Access for Peripheral Transluminal Angioplasty
The radial approach is currently gaining popularity in the setting of coronary percutaneous transluminal angioplasty (PTA) because it decreases the incidence of vascular complications. This study reports the initial results with radial access for peripheral PTA.
Outcomes of Interventions via a Transradial Approach for Dysfunctional Brescia-Cimino Fistulas
The transradial artery approach to angioplasty has rarely been reported as a method for treating dysfunctional Brescia-Cimino ﬁstulas. This study evaluated the feasibility, safety, and 1-year efﬁcacy of this method for treating dysfunctional Brescia-Cimino ﬁstulas.
Evaluation of the Ulnopalmar Arterial Arches with Pulse Oximetry and Plethysmography: Comparison with the Allen’s Test in 1010 Patients
Study that evaluated the patency of the hand collateral arteries and to compare MAT with combined plethysmography (PL) and pulse oximetry (OX) tests before the percutaneous transradial approach.
Transradial Approach for Transcatheter Arterial Chemoembolization in Patients With Hepatocellular Carcinoma
Article evaluates the clinical usefulness and safety of transradial approach for transcatheter arterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC) compared with that of conventional transfemoral approach.