Transradial and transulnar access for iliac artery interventions using sheathless guiding systems: A feasibility...

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Endovascular Interventions

Background:

• Iliac artery stenosis significantly impacts patient mobility and limb viability.
• Traditional femoral access for stenting carries risks of bleeding and vascular complications.
• Minimally invasive approaches aim to improve procedural safety and patient outcomes.

Purpose of the Study:

• To evaluate the acute success and complication rates of transradial and transulnar access for iliac artery stenting.
• To assess the efficacy of sheathless guiding systems in these endovascular procedures.
• To compare outcomes between transradial and transulnar access methods.

Main Methods:

• Retrospective analysis of 156 consecutive patients with symptomatic iliac artery stenosis.
• Procedures performed using transradial or transulnar access with sheathless guiding systems.
• Primary endpoints included procedural success, major adverse events, and access site complications; secondary endpoints assessed angiographic results, radiation dose, and procedure duration.

Main Results:

• High technical success rate (99.4%) was achieved with transradial (96.8%) and transulnar (4.5%) access.
• Ankle-brachial index significantly improved post-intervention (P < 0.001).
• Major adverse events occurred in 3.8% of patients; radial access site complications in 5.1%. X-ray dose decreased over time, indicating a learning curve effect.

Conclusions:

• Iliac artery stenting using radial or ulnar artery access with sheathless guiding catheters is safe and effective.
• The procedure demonstrates high technical success and acceptable complication rates.
• Physician experience, or learning curve, is crucial for reducing radiation exposure.