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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.
The Journal of Vascular Access
|December 10, 2020
Summary
Distal transradial artery access (dTRA) offers a safe and effective method for dialysis vascular access interventions. This technique demonstrates a 100% success rate with no complications, improving patient outcomes.
Area of Science:
- Interventional Nephrology
- Vascular Surgery
- Dialysis Access Management
Background:
- Arteriovenous fistula (AVF) maintenance in dialysis patients often requires vascular access intervention.
- Outflow veins are typical access sites, but radial artery access is used when venous access is challenging.
- Distal forearm AVF interventions via radial artery can be technically difficult.
Purpose of the Study:
- To evaluate the efficacy and safety of distal transradial artery (dTRA) access for vascular access interventions.
- To assess the feasibility of dTRA in challenging distal forearm AVF cases.
Main Methods:
- A case series evaluating 12 vascular access interventions using dTRA access from January to December 2019.
- Assessment of procedure success rate, complications, procedure time, fluoroscopy time, and contrast volume.
Main Results:
- Achieved a 100% procedural success rate in all 12 cases.
- Observed no puncture-related hemorrhagic complications or radial artery occlusions.
- Reported an average fluoroscopy time of 11.5 minutes and an average contrast volume of 41 ml.
Conclusions:
- Distal transradial artery (dTRA) access is a safe and effective option for vascular access interventions.
- dTRA offers improved safety and easier hemostasis compared to conventional radial artery access.
- This technique facilitates interventions in challenging distal forearm arteriovenous fistulas.
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