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Published on: September 20, 2020
Results from a multicenter retrospective study of transradial iliac artery stenting in Japan
Norihiko Shinozaki1,2, Yusuke Iwasaki3, Hideki Doi4
1Department of Cardiology, Asama General Hospital, 1862-1 Iwamurada, Saku, Nagano, Japan. shinori3@aol.com.
Insights
Transradial iliac artery stenting is a safe and feasible procedure for carefully selected patients, showing significant improvement in ankle-brachial index with minimal complications. This multicenter study highlights its potential as an alternative to the transfemoral approach.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Endovascular Interventions
Background:
- Lack of large-scale multicenter studies on transradial iliac artery stenting safety and effectiveness.
- Need for evidence supporting minimally invasive approaches for peripheral artery disease.
Purpose of the Study:
- To evaluate the safety and feasibility of transradial iliac artery stenting.
- To assess clinical outcomes and complications associated with this approach.
Main Methods:
- Retrospective analysis of a multicenter database from Japan.
- 115 transradial iliac artery stenting procedures in 105 patients.
- Exclusion of patients requiring bidirectional access; operator discretion for access site.
Main Results:
- Successful stent implantation in all lesions, with a significant improvement in ankle-brachial index (0.65 to 0.95, P < 0.0001).
- Low complication rate: 3.8% required additional femoral artery puncture; 2.9% asymptomatic radial artery occlusion.
- No procedural or access site-related complications, and no target lesion revascularizations at 1 month.
Conclusions:
- Transradial iliac artery stenting is safe and feasible in carefully selected patients.
- It offers comparable outcomes to the traditional transfemoral approach without specific complications.
- Further research can explore its broader application in treating iliac artery disease.
Abstract:
Large-scale multicenter studies demonstrating the safety and effectiveness of transradial iliac artery stenting are lacking. We evaluated the data from a multicenter database in Japan. Transradial iliac artery stenting was performed on 115 lesions in 105 patients. The approach site was determined at the discretion of the operator. Patients with scheduled multiple sheath insertions for the bidirectional approach were excluded. Clinical data were retrospectively analyzed. The average age of this cohort was 71.1 ± 8.3 years. Eighty-six patients (81.9%) were male. Diabetes mellitus, hypertension, dyslipidemia, and smoking habit were present in 39 (37.1%), 84 (80.0%), 69 (65.7%), and 78 patients (74.3%), respectively. Rutherford classifications 1, 2, 3, 4, and 5 comprised 40 (34.8%), 42 (36.5%), 28 (24.3%), 3 (2.6%), and 2 (1.7%) lesions, respectively, while Trans-Atlantic Inter-Society Consensus II classifications A, B, C, and D comprised 74 (64.3%), 21 (18.3%), 15 (13.0%), and 5 (4.3%), respectively. Twenty-seven lesions (23.5%) had chronic total occlusion. All lesions were successfully treated with 141 stents. Four patients (3.8%) required additional puncture of the common femoral artery for successful stent implantation. The ankle-brachial index significantly improved from 0.65 ± 0.17 to 0.95 ± 0.15 (P < 0.0001). None of the patients experienced any procedural or access site-related complications. Asymptomatic radial artery occlusion was observed in three cases (2.9%) after the procedure. There were no target lesion revascularizations or complications at 1 month. Compared to the traditional transfemoral approach, transradial iliac artery stenting is safe and feasible without any specific complications in carefully selected patients.
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