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Distal transradial artery access for vascular access intervention
Shingo Watanabe1, Michio Usui1
1The Department of Cardiology, Tokyo Yamate Medical Center, Shinjuku-ku, Tokyo, Japan.
Background:
Vascular access intervention is a useful treatment method for maintaining arteriovenous fistula (AVF) in dialysis patients. The outflow vein is commonly used as the access site for vascular access intervention. In cases where it is difficult to puncture veins due to multiple lesions or poor AVF development, vascular access intervention is performed using the radial artery. However, it is difficult to perform a vascular access intervention with radial artery access to the AVF in the distal forearm. We reported the efficacy and safety of vascular access intervention with distal transradial artery access (dTRA).
Case Series:
We have been conducting vascular access intervention with dTRA access since January 2019. We evaluated complications and procedure time for 12 cases of vascular access intervention with dTRA access performed from January to December 2019.The success rate of the procedure was 100% and no puncture hemorrhagic complication was observed in 12 cases performed at our institution. No radial artery occlusion was observed in 12 cases. The average fluoroscopy time was 11.5 min and the average contrast volume was 41 ml.
Conclusion:
dTRA for vascular access intervention has advantages over conventional radial artery access in terms of safety of the procedure and ease of hemostasis.
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Assessment of radial pulse
The radial pulse, located at the wrist, is often the preferred site for assessing peripheral pulse because of its accessibility and dependability. The process of determining the radial pulse involves several steps:
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The A-R pulse assessment involves simultaneous evaluation of the apical and radial pulses. When the apical and radial pulse rates vary, this assessment helps identify a pulse deficit.
Pre-Procedural Preparation
Peripheral Artery Disease III: Interprofessional Care
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Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation

