Percutaneous transaxillary approach for peripheral endovascular interventions

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Endovascular Interventions

Background:

• Common femoral artery (CFA) is the standard access site for peripheral endovascular interventions but may not always be suitable.
• The axillary artery offers a comparable size to the CFA and is less prone to atherosclerosis.
• Limited data exist on the percutaneous use of the axillary artery for these procedures.

Purpose of the Study:

• To evaluate the safety and feasibility of percutaneous transaxillary (TAx) access for peripheral endovascular interventions.
• To assess access-related complications and major adverse events (MAEs).

Main Methods:

• Retrospective analysis of consecutive patients undergoing percutaneous TAx peripheral endovascular interventions.
• Data collection included demographics, procedural details, and outcomes.
• Access was achieved percutaneously with the arm abducted, followed by sheath placement and intervention.
• Vascular closure devices were used for hemostasis.

Main Results:

• Successfully performed 41 procedures in 29 patients lacking suitable conventional access.
• Target vessels were predominantly infrainguinal (75%), with many complex lesions (61% TASC C or D).
• Low access-related complication rate (5%) and no major adverse events (MAEs) were observed.
• Median procedure time was 135 minutes, with a 1-day length of stay.

Conclusions:

• Percutaneous TAx access is a feasible and safe alternative for lower extremity endovascular interventions when conventional access is unavailable.
• Proficiency in the TAx approach is a valuable skill for interventionalists.